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Reply with quote  #1 

In the medical decision making I am wondering if a physician can count ordering EKG = 1 and Independent visualizing it also - 2 points a total of 3 points.  If he cannot where is documentation to back this?


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Reply with quote  #2 

It depends.  If you order and EKG in the hospital and then interpret the EKG, there is little doubt that you would get credit for both quantums of cognitive labor (i.e., one point for ordering the test and two points for reviewing the tracing and recording your findings in the chart.)  However, in the office, if you are charging separately for the EKG, then the interpretation is already incorporated in to the fee for that service, so it would not be appropriate to also "charge" two data points as well.  Most carriers have adopted a compromise solution where the doc will get the one point for ordering the EKG but not get the two points for interpreting the image (if the office is charging for the EKG).  On the other hand, if you are not charging separately for the EKG, then it would probably be okay to claim points both for ordering and interpreting the test.  The final answer, as always, rests with your own Medicare carrier.  Make sure you get an anwer to this question from them in writing.  And let us know if you do....so other docs can benefit as well.


Thanks for your question.



Reply with quote  #3 
HOw about if the hospital charges for the facility fee for EKG, but the professional fee is not being paid to the physician or the EKG is no reimbursed at all. Can you get two points if you order and interpret an EKG in the office visit? 
Is there any difference between medicare and private carriers?
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