Medical Billing Forum

Coding => Coding => Topic started by: Michele on July 25, 2014, 07:53:18 AM

Title: EKG testing in hospital setting
Post by: Michele on July 25, 2014, 07:53:18 AM
Question sent to me by someone having difficulty logging into forum:

If EKG is done at inpatient setting (unit floor) may hospital bill for 93005 - tracing? Or EKG tracing is bundled with inpatient bundling rule.

Physician reading the EKG billing 93010

I would appreciate any website or article for reference.
Primary payer is Medicare. 

Also, for hospital billing, if lab test is ordered by other doctor than attending, who's NPI should be reported  on UB -04 box 76 ordering or attending doctor NPI?
   
Title: Re: EKG testing in hospital setting
Post by: RichardP on July 25, 2014, 12:03:21 PM
RE: 93005 - whoever did the activity that the 93005 covers should be the one to bill for it.

Indicator 3: TC only codes. This indicator identifies stand-alone codes that describe the TC (e.g., staff and equipment costs) of selected diagnostic tests for which there is an associated code that describes the PC of the diagnostic test only. An example of a TC only code is CPT code 93005: Electrocardiogram; tracing only, without interpretation and report. It also identifies codes that are covered only as diagnostic tests and therefore do not have a related professional code. Neither CPT modifier 26 nor HCPCS modifier TC can be submitted with these codes.

From here:
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Jurisdiction-11-Part-B~8EELCU0558

We don't do UB-04 billing, so maybe my answer doesn't address the question??


Title: Re: EKG testing in hospital setting
Post by: Michele on July 30, 2014, 11:18:43 AM

Also, for hospital billing, if lab test is ordered by other doctor than attending, who's NPI should be reported  on UB -04 box 76 ordering or attending doctor NPI?[/b]   


Are you billing for the lab test only?  If there are other items on the claim I would think you would still use the attending dr, if you are billing the lab test only then the ordering dr could be there.  Also, you could use box 78 as well.