Thanks for the help on the ECG Over-read issue!

First, a big THANK YOU! to everyone who responded to the "ECG Over-reads" question this past week!  

Come to find its a CMS rule -- and NOT JCAHO.  It's really a coding question!      

                                                                

Medicare will pay for 1 interpretation, and only 1.   

We cover it in RN-Coder BASIC Training when we discuss:

93000 - Only a physician with her/his own EKG machine can "claim" this code -- because they own the machine & they did the interpretation & report of the results.  

Remember, ANY physician is qualified to run an ECG, not just a cardiologist.

93005 - ECG; tracing only --what the hospital would charge in the ED or a clinic -  for the machine

93010 - ECG; interp & report only -- what the cardiologist should be charging for the "over-read"

So usually the ED doc will use the # of tests, x-rays, etc. s/he has to order & "read" on the spot to build the level of E/M visit they will bill.  Remember, our discussion about "Medical Decision Making"?

Then the cardiologist would bill the 93010  and  the hospital would bill 93005.  

There have been MANY problems and MANY investigations -- especially when a cardiologist is paid for the over-reads by the hospital & then bills Medicare for it -- or the 93000!