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Cardiology Coding Alert

Reader Question:

Think You Can Report 2 E/Ms? Think Again

Question: A patient who was not feeling well came into the office, and the physician performed an ECG that proved the patient was in a-fib. The cardiologist immediately sent the patient to the hospital. I reported 99214 and 93000 with diagnosis a-fib and was paid. Another cardiologist from our group saw the patient the same day in the hospital. How can I get paid for the services provided in the hospital by the second cardiologist, who is billing under the same tax ID number with the same diagnosis ? Arkansas Subscriber
Answer: Typically, you can bill only one E/M service per day per practice. You should charge 93000 (Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report) as well as your hospital charge, such as the appropriate level of initial hospital care (99221-99223). In order to secure payment for two E/M services by physicians of the same specialty, you would have to prove the medical necessity for concurrent care. This is a hassle not commonly worth the additional reimbursement at stake.

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