tci ED Coding & Reimbursement Alert - 2022 Issue Q4

Reader Questions: Look for More Accurate Code Before Using Modifier 52

Question: Encounter notes indicate that the ED physician performed an evaluation and management (E/M) service for a patient that was complaining of chest pains. There was medical decision making (MDM) of moderate complexity along with a detailed history. The physician then ordered a 12-lead electrocardiogram (ECG), but only performed the interpretation and report. Final diagnosis was pleurodynia. Should I report 93000 with modifier 52 appended? Iowa Subscriber Answer: No, you should instead report 93010 (Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only) for the ECG with 99284 (Emergency department visit for the evaluation and management...

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