EKGs inclusive of Cardiac Procedures
In general, we know that most cardiac procedures include an EKG (or two), this can be factored into the charge for the procedure. However, when multiple EKGs are performed during and following a procedure, our Coding team is stating that we cannot separately bill for the additional EKGs if they are related to the procedure and we should not charge for them at all.
I understand that they would not be separately reimbursed by most payors, but how would we properly capture and report costs if we don't charge for them?
I would appreciate any thoughts on this.
BTW, we are on Epic.
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I would be interested too as this is an issue for my hospital. Our departments use posted charges for productivity. So far suggestions have been to use a bogus revenue code that drops charges off claims or rules that write off these charges before billing. Not sure yet of the final outcome.
Do they have an internal system that tracks the number of EKGs they perform? Many hospitals are moving to this type of tracking (e.g., Radiology) rather than the CDM. It's hard to capture items for productivity when they are not separately chargeable (included in a procedure) and writing off a charge is not ideal. It would be work investigating to see if your system has a mechanism for rolling these line items into the procedure charge and not billing a CPT code for the additional EKGs. That way, you capture the productivity and the additional cost that was medically necessary for the individual patient.