Health Information Management

Monitoring integral to surgery

APCs Insider, March 5, 2004

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QUESTION: When a patient is under general anesthesia, a 3-lead electrocardiogram (EKG), CPT 93041 is performed. Is this considered bundled into the APC rate as monitoring of anesthesia or is it a separate procedure that needs to be billed under the APC system? We checked the Correct Coding Initiative (CCI) edits and do not see that the surgery HCPCS and the 93041 CPT cannot be billed together.

ANSWER: With the current CCI edits, you are correct that no edit will prohibit the combination of a surgery CPT code along with 93041, 3-lead EKG. However, monitoring with 3-lead EKG would not be provided if it were not for the surgery. Therefore, the 3-lead EKG is considered part of the patient's operative needs or surgical services and a separate charge identified by CPT code 93041 is not allowed, according to Program Memorandum A-01-133. The monitoring is integral to the surgical services and packaged into the surgery services APC payment.



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