Billing and Coding: Electrocardiograms

ECGs are covered only when medically necessary and relevant to patient management and may be separately paid if not part of a cardiac stress test and if they add clinical information (e.g., to rule out acute MI), but are excluded for screening or routine physicals. Key requirements: repeat ECGs for technical inadequacy cannot be billed as extra, rhythm strip interpretation/tracings are bundled into 12‑lead codes (report one unit per date), and if separate physicians bill rhythm and 12‑lead on the same day both services must be reasonable and necessary (usually requiring prolonged monitoring).

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