Billing and Coding: Electrocardiograms

Medicare covers ECGs when they are reasonable and necessary for the management, diagnosis, or treatment of a patient, including rhythm ECGs for symptoms of arrhythmia and separate same-day ECGs when they provide information beyond a scheduled stress test (for example to rule out acute MI). Routine screening or ECGs performed solely as part of a physical exam are not covered; multiple interpretations or duplicate technical/professional components are generally not payable except under unusual, well-documented circumstances. Documentation must include a complete, separately identifiable written interpretation addressing findings and comparative data, and frequency is limited generally to annual testing for stable patients while allowing multiple tests for acute or unstable conditions.

"An ECG is covered when the result is relevant to the management, diagnosis, or treatment of the patient."