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ECG Insurance Reimbursement

A 12-lead ECG is the gold standard of measuring heart rhythms and spotting irregularities. Six leads are applied to the patient’s chest, while the remaining 6 leads are divided among the patients’ extremities. The heart’s electrical activity generates a current that spreads to the skin. Each lead contains a sensor that measures the electrical activity sent from the sinoatrial node through the heart. The most basic devices simply record this information onto paper. Smart ECGs take this process several steps further by integrating algorithms that help the physician interpret the results.

For example, nCardio’s internally developed filtering and detection algorithms identify and classify various cardiac abnormalities. The reading generates standard and extended measurements that include an extended capture of up to 40 seconds full-disclosure and markings for 15 independent events. Upon completion, human-centered augmented intelligence provides diagnostics and reporting that support clinical decisions.

This combination of a routine ECG with 12 leads along with interpretation and reporting can be billed with CPT code #93000. This code reports both the professional and technical components of the service. The ECG test is typically covered when there are documented signs and symptoms or other clinical indications for providing the service. The average amount that healthcare providers can be reimbursed for the service typically ranges from $10-$20.

Coverage is often only provided when the review and interpretation is completed by a physician and the device is owned by the ordering provider. When submitting for CPT code #93000 reimbursement, remember to include the full graphic tracings and a formal written report with the interpretation and signature from the physician. nCardio provides the tracings and reporting needed for your submissions.

For situations without the interpretation and report, when only the tracing is completed during the electrocardiogram, the CPT code #93005 can be used. The average reimbursement is about $9.

nCardio provides each element that is needed for your insurance reimbursement for both codes. This streamlines the billing process and makes it easier to get reimbursed.

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