EKG Inquiry

June 15, 2011

When counting points for the data reviewed in E&M, do you count "independent review of image, tracing, or specimen" (two points), for example, when a cardiologist sees a patient, interprets an EKG, and provides an E&M service?

Question: When counting points for the data reviewed in E&M, do you count "independent review of image, tracing, or specimen" (two points), for example, when a cardiologist sees a patient, interprets an EKG, and provides an E&M service?

Answer: This one depends on whether the physician billed the EKG (93000 or 93010) in addition to the E&M. If she billed the interpretation she cannot also count the two points for reading the EKG as part of the MDM calculation - she has already been paid for that in the EKG code. If the physician doesn't bill for the EKG, count the points if she visualizes the tracing.

Bill Dacey, CPC, MBA, MHA, is principal in the Dacey Group, a consulting firm dedicated to coding, billing, documentation, and compliance concerns. Dacey is a PMCC-certified instructor and has been active in physician training for more than 20 years. He can be reached at billdacey@msn.com or editor@physicianspractice.com.

This article originally appeared in the May 2011 issue of Physicians Practice.