Health Information Management

Q/A: Report modifier -59 for EKGs performed before or after cardiac catheterization

APCs Insider, August 7, 2009

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Q. An APC edit states that 93005 (electrocardiogram, routine EKG with at least 12 leads; tracing only, without interpretation and report) is a part of comprehensive procedure 93510 (left heart catheterization) and allowed with an appropriate modifier. We always order and perform EKGs before these procedures. Should we add a modifier? Can you direct me to relevant CMS guidance?
 
A. CMS Version 14.2 of the National Correct Coding Initiative (NCCI) Manual states the following:
 
“Cardiac catheterization procedures may require procurement of EKG tracings during the procedure to assess chest pain during catheterization and angioplasty; when performed in this fashion, these EKG tracings are not separately reported. EKGs procured prior to, or after, the procedure may be separately reported with modifier -59.”



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