History
8/03 Original policy issued.
10/03 Medical Policy Advisory Group review. No changes to policy. Reaffirm.
02/05 Added the following statement to the Principles section of the policy. “The interpretation or the fee for the interpretation should be submitted based on place of service where the ECG was performed.
04/07/05 Medical Policy Advisory Group reviewed policy on 03/10/2005. Typos corrected.
5/08/06 Medical Policy Advisory Group review 3/24/06. No change to policy criteria. Policy number added to the Key Words Section.
3/26/07 Medical Policy reviewed by Senior Medical Director of Network Support.
05/05/08 No changes to policy criteria. Policy reviewed 04/04/2008 by Vice President and Senior Medical Director of Provider Partnerships, Medical and Reimbursement Policy. Policy status changed to “Active policy, no longer scheduled for routine literature review.”
6/22/10 Policy Number(s) removed (amw)
4/26/11 Added the following statements to the “Criteria for Reimbursement” section: “Please note: In light of the recent advances in information technology, specifically the development of electronic health records (AND), BCBSNC will accept documentation of the above criteria in AND format. This includes the physician’s interpretation and electronic signature.” (mco)
3/6/12 Policy returned to “active review” status. The following was added to the Principles section Item 4. “Global only” codes represent a routine ECG with at least 12 leads and include the physician’s interpretation and report. Other CPT codes are established to specify the “technical” component, (the ECG tracing only), and the “professional” component (for interpretation and report only). It is not appropriate to use modifiers -26 or –TC with these latter codes. Item 5. When Rhythm ECG, interpretation and report only, is billed the same date as an Evaluation and Management service in the hospital setting, then the rhythm ECG will be denied as a component of the Evaluation and Management service. (and)
12/10/13 Routine policy review. Name of policy changed from “ECG Reimbursement Issues” to “ECG Reimbursement.” (and)
5/13/14 Policy category changed from “Corporate Medical Policy” to “Corporate Reimbursement Policy”. No changes to policy content. (and)
4/28/15 Routine policy review. Revised wording in Policy Guidelines section. Medical records may be requested for determination of correct coding. Otherwise, no changes to policy content. (and)
12/30/16 Routine policy review. No change to policy statement. (an)
12/29/17 Routine policy review. No change to policy statement. (an)
12/14/18 Routine policy review. No change to policy statement. (an)
3/12/19 The following statement was deleted from the section titled “Criteria for Reimbursement of Professional Interpretation of ECGs”: Based on information obtained from the hospital and provider, BCBSNC will determine which providers are eligible for reimbursement for the professional component of ECGs performed in the emergency room. (an)
1/14/20 Routine policy review. Senior Medical Director approved 12/2019. No changes to policy statement. (an)
12/31/20 Routine policy review. Medical Director approved 12/2020. No changes to policy statement. (eel)
4/20/21 Policy format update. No changes to policy statement. (eel)
12/30/21 Routine policy review. Medical Director approved. (eel)
12/31/2022 Routine policy review. Minor revisions only. (ckb)