Electrocardiograms

LCD Information Document Information Source LCD ID N/A LCD ID L34315 Original ICD-9 LCD ID Not Applicable LCD Title Electrocardiograms Proposed LCD in Comment Period N/A Source Proposed LCD DL34315 Opens in a new window Original Effective Date For services performed on or after 10/01/2015 Revision Effective Date For services performed on or after 11/06/2025 Revision Ending Date N/A Retirement Date N/A Notice Period Start Date 02/07/2018 Notice Period End Date 03/25/2018 CPT codes, descriptions, and other data only are copyright 2025 American Medical Association. All Rights Reserved. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein. CPT is a registered trademark of the American Medical Association. 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Issue Issue Description This update is to consolidate JE and JF to have one unified document and policy number. Issue - Explanation of Change Between Proposed LCD and Final LCD CMS National Coverage Policy Coverage Indications, Limitations, and/or Medical Necessity The electrocardiogram (ECG, EKG) and ECG rhythm strip records the electrical activity of the heart throughout the cardiac cycle of contraction (depolarization) and relaxation (repolarization). The changes in electrical potential during the cardiac cycle are detected at the body surface and recorded on graph paper. The recording is reviewed by a physician who provides an interpretation and written report. An ECG may be reported as the technical aspect only, the interpretation and written report only, or both aspects together as one service. The electrical activity of the heart can be viewed along various electrical axes (viewpoints). Each viewpoint is described as a "lead”. A typical ECG views the heart from 12 axes and, therefore, has 12 leads. A rhythm strip typically includes one to three leads. Typically, a 12-lead ECG is a separate document from the medical progress notes, while a printed rhythm strip may be pasted into the progress notes.An ECG is indicated to diagnose or treat a patient for symptoms, signs, or a history of heart disease; or systemic conditions that affect the heart, including: Chest pain or angina pectoris, Myocardial ischemia or infarction, Arteriovascular disease including coronary, central, and peripheral disease, Hypertension, Conduction abnormalities, Cardiac rhythm disturbances, Cardiac hypertrophy, Heart failure, Pericarditis, Structural cardiac conditions, Endocrine abnormalities, Neurological disorders affecting the heart, Syncope, Paroxysmal weakness, Palpitations, Sudden lightheadedness, Electrolyte imbalance, Acid-base disorders, Temperature disorders, Pulmonary disorders, and Drug cardiotoxicity. An ECG may help identify cardiac disorders as part of a preoperative clinical evaluation. A preoperative ECG may be reasonable and necessary under one of the following conditions: In the presence of pre-existing heart disease such as congestive heart failure, prior myocardial infarction (MI), angina, coronary artery disease, or dysrhythmias; In the presence of known comorbid conditions that may affect the heart, such as chronic pulmonary disease, peripheral vascular disease, diabetes, or renal impairment; or When the pending surgery requires a general or regional anesthetic. Summary of Evidence NA Analysis of Evidence (Rationale for Determination) NA

The electrocardiogram (ECG, EKG) and ECG rhythm strip records the electrical activity of the heart throughout the cardiac cycle of contraction (depolarization) and relaxation (repolarization). The changes in electrical potential during the cardiac cycle are detected at the body surface and recorded on graph paper. The recording is reviewed by a physician who provides an interpretation and written report. An ECG may be reported as the technical aspect only, the interpretation and written report only, or both aspects together as one service. The electrical activity of the heart can be viewed along various electrical axes (viewpoints). Each viewpoint is described as a "lead”. A typical ECG views the heart from 12 axes and, therefore, has 12 leads. A rhythm strip typically includes one to three leads. Typically, a 12-lead ECG is a separate document from the medical progress notes, while a printed rhythm strip may be pasted into the progress notes. An ECG is indicated to diagnose or treat a patient for symptoms, signs, or a history of heart disease; or systemic conditions that affect the heart, including: Chest pain or angina pectoris, Myocardial ischemia or infarction, Arteriovascular disease including coronary, central, and peripheral disease, Hypertension, Conduction abnormalities, Cardiac rhythm disturbances, Cardiac hypertrophy, Heart failure, Pericarditis, Structural cardiac conditions, Endocrine abnormalities, Neurological disorders affecting the heart, Syncope, Paroxysmal weakness, Palpitations, Sudden lightheadedness, Electrolyte imbalance, Acid-base disorders, Temperature disorders, Pulmonary disorders, and Drug cardiotoxicity. An ECG may help identify cardiac disorders as part of a preoperative clinical evaluation. A preoperative ECG may be reasonable and necessary under one of the following conditions: In the presence of pre-existing heart disease such as congestive heart failure, prior myocardial infarction (MI), angina, coronary artery disease, or dysrhythmias; In the presence of known comorbid conditions that may affect the heart, such as chronic pulmonary disease, peripheral vascular disease, diabetes, or renal impairment; or When the pending surgery requires a general or regional anesthetic.