ECG Guidelines for Infusion Services and Clinical Trials Unit

ECG Type
(Infusion Services) / ECG
(clinical symptoms) / ECG-RS (A) / ECG-B / ECG-C / ECG-D / ECG-E
Who owns the ECG machine? / SCCA / SCCA / SCCA / SCCA / Study Sponsor / Study Sponsor
Who does ECG? / SCCA Staff / SCCA Staff / SCCA Staff / SCCA Staff / Research & SCCA Staff / Research Staff
Who reads ECG? / UW Cardiology / UW Cardiology / UW Cardiology / Not applicable. No formal read needed; PI or designee will review. / Research Cardiology Group (off-site) / Research Cardiology Group (off-site)
Who pays SCCA facility fee? / Pt/Pt’s insurance (aka standard, routine, or usual care) / Pt/Pt’s insurance (pt enrolled in deemed qualified study allowing billing of research related activity to insurance). / Study budget (via RRR account) / Study budget (via RRR account) / Study budget (via RRR account) / Not applicable. ECG conducted on study sponsor provided machine.
Who pays UWP pro fee? / Pt/Pt’s insurance (aka standard, routine, or usual care) / Pt/Pt’s insurance (pt enrolled in deemed qualified study allowing billing of research related activity to insurance) / Study budget (via RRR account) / Not applicable. No formal read required by UWMC Cardiology. / Not applicable (ECG sent to Research Cardiology group to be read and billed) / Not applicable. (ECG sent to Research Cardiology group to be read and billed)
What are PI or study staff responsibilities? / N/A / Complete SRO to schedule infusion treatment appointment.
Include the type, quantity and indication/reason for the ECG(s) in Scheduling Comments section.
Note ECG type on chemotherapy and supportive therapy order.
Cardiology-ECG fee sheet initiated by research staff. / Complete SRO to schedule infusion treatment appointment including RRR billing.
Include the type, quantity and indication/reason for the ECG(s) in Scheduling Comments section.
Complete UWMC Cardiology-ECG pro fee sheet(s) including use of RRR account stickers.
Complete an Anticipated Research Services Checklist.
Submit completed pro fee sheet to RN/NAC on day of ECG. / Complete SRO to schedule infusion treatment appointment including:
  • RRR billing information.
  • Instructions to RN/NAC on where to leave hardcopy ECG for study staff/PI pick-up.
  • Include the type, quantity and indication/reason for the ECG(s) in Scheduling Comments section.
Complete an Anticipated Research Services Checklist. / Complete SRO to schedule infusion treatment appointment including:
  • RRR billing information.
  • Include the type, quantity and indication/reason for the ECG(s) in Scheduling Comments section.
Complete an Anticipated Research Services Checklist.
Perform ECG(s) / Complete SRO to schedule infusion treatment appointment.
Include the type, quantity and indication/reason for the ECG(s) in Scheduling Comments section.
Perform ECG(s)
What are TC responsibilities? / N/A / Include ECG type, quantity and the indication/reason for the ECG(s) in Infusion appointment notes in Epic. / Include ECG type, quantity and the indication/reason for the ECG(s) in Infusion appointment notes in Epic. / Include ECG type and quantity in Infusion appointment notes in Epic. / Include ECG type and quantity in Infusion appointment notes in Epic. / Include ECG type and quantity in Infusion appointment notes in Epic.
What are RN/NAC responsibilities? / Perform ECG(s)
Indicate 93005 for “Tracing”.
Complete and submit Cardiology-ECG fee sheet. / Perform ECG(s)
Indicate 93010 for “Tracing”
Cardiology-ECG fee sheet initiated by research staff and then completed by Infusion RN/NAC. Submit UWMC Cardiology-ECG fee sheet noting “RS”. / Perform ECG(s)
Indicate 93010 for “Tracing”
Route the completed UWMC Cardiology-ECG fee sheet(s) to UW Cardiology with ECG(s). / Perform ECG(s)
Delete ECG(s). Do not transmit to UWMC.
Note: No Cardiology-ECG pro fee sheet needed b/c no formal interpretation performed. / Place ECG machine leads.
Remove ECG machine leads when completed.
Confirm that appointment note states “RN/NAC to assist” to ensure appropriate billing. / None

J:\Research Implementation\EKG issues\ECG Guidelines for Infusion and CTU 12-11.doc