The newest outpatient cardiac monitoring services (ECAT, MCOT, ACT) are not Medicare-approved for the diagnosis "785.1 Palpitations". For patients presenting with palpitations, many doctors and staff have been told by salespeople to use the code "426.9 Conduction Disorder - Unspecified" in place of the palpitations code or in conjunction with, as a secondary diagnosis, even if there is no patient history of a conduction disorder. This results in claims being paid rather than declined, since conduction disorder is an approved Medicare diagnosis for this type of monitoring.
Are conduction disorders typically diagnosed after EKG testing? Or are they diagnosed like palpitations, like a symptom? Are the two diagnoses inter-related? Can you shed some light on this?
I need to evaluate whether or not this type of stuff is common practice and/or ethical.
I really appreciate your help.