tci ED Coding & Reimbursement Alert - 2002 Issue 11

READER QUESTION: EKG Interpretation

Question: How do AMA and Medicare guidelines differ for coding an emergency physician's interpretations of an EKG? Washington SubscriberAnswer: According to both AMA and Medicare guidelines, you need a separate, distinctly written report documenting the physician's EKG interpretation. But Medicare requires more than just a report. You must present documentation that indicates that the physician's interpretation was additional to the report covered by the E/M codes and similar to that of a specialist in the field. E/M payment already covers EKG reviews, so Medicare will not reimburse the professional component of EKG interpretations unless you append your claim with...

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