The standard 12-lead Electrocardiogram (ECG/EKG) is billed using the 93000 series. Whether you bill 93000, 93005, or 93010 depends entirely on who owns the equipment and who reads the results.
Global vs Component Billing
- 93000 (Global): You own the EKG machine (the technical component) AND your physician interprets the report (professional component).
- 93005 (Tracing Only): You only perform the test (e.g., a hospital or facility), but an outside cardiologist reads it.
- 93010 (Interpretation Only): The physician reads the EKG, but did not own the equipment or perform the tracing.
Medical Necessity: Routine vs Pre-Op
Medicare rarely pays for "routine" screening EKGs. You must have a diagnosis showing signs/symptoms of heart disease (e.g., chest pain, palpitations). If done for pre-operative clearance, use Z01.810 (Encounter for preprocedural cardiovascular examination) combined with the reason for the surgery.
NCCI Edits
93000 is heavily bundled into emergency department visits and critical care codes. Check your NCCI edits before billing an EKG with high-level E/M services.