tci Outpatient Facility Coding Alert - 2015 Issue 7

Reader Questions: EKG and Cardioversions Are Not Bundled Together

Question: We do a pre- and post-EKG on every elective cardioversion patient. The CCI edits shows that the only way to bypass the edits is to assign the 59 modifier. Is it appropriate as we “always” do a pre- and post-EKG in these situations? Utah Subscriber Answer: You can bill the EKG following the cardioversion; however, medical necessity must be met.  Performing an EKG routinely in every situation would constitute a standard of care.  In those situations where medical necessity criteria have been substantiated, you should submit 92960 (Cardioversion, elective, electrical conversion of arrhythmia; external) with...

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