As per HUMANA, for a patient 18 years of age or older, a charge for routine ECG is not eligible for reimbursement when submitted with an office place of service and a diagnosis of the general medical exam or cardiovascular screening.
The U.S. Preventive Services Task Force (USPSTF) discourages the use of ECG for asymptomatic adults at low risk for coronary heart disease (CHD) events.Humana to be consistent with USPSTF recommendations, has determined that such routine ECG is not medically necessary and, therefore, is not covered.
This will applicable only for the Medicaid – Florida and it will affect all the Inpatient/Outpatient Facilities and Physicians/Health Care Providers effective from 08/03/2017.
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