An internal review of chest pain cases has demonstrated that many claims for ECGs performed to investigate a possible diagnosis of Acute Coronary Syndrome do not align with the Acute Chest Pain HealthPathway
A normal ECG alone cannot rule out Acute Coronary Syndrome (ACS). Unless admitting to hospital based on ECG review, troponin must be sent to the laboratory and reviewed as soon as practical for the ECG funding criteria to be met in cases where possible ACS is being investigated.
In cases where ECG has been performed for chest pain possibly related to acute coronary syndrome, if there is no evidence that a troponin test has also been performed, the POAC ECG claim will be declined.
We would appreciate if this could be reviewed within your clinical teams to ensure practice policies are in alignment with the HealthPathway requirements.
Note that when ECG is performed to investigate acute chest pain where ACS is not under investigation or is not a likely differential diagnosis and this is made clear in the notes provided , concurrent troponin testing is not mandatory for POAC funding.