Tuesday, July 13, 2021

Cardiovascular Monitoring Services

 “Spotlight on CPT” this month takes a look at cardiovascular monitoring services.  With constant improvements in technology, it is no wonder that cardiovascular monitoring services are continuing to evolve. 

Holter monitors, as pictured on the left below, were one of the first methods of continuous recording of electrocardiographic (ECG) data.  These devices can include up to 48 hours of continuous recording.  The codes are in the 93224-93227 range.  93224 is the comprehensive code which includes the recording, scanning analysis with report, review and interpretation by the physician or other qualified healthcare professional.  Each of the remaining codes breaks out each piece of the comprehensive code, so only the specific component performed is billed, when the comprehensive service is not done.  This includes 93225 for the recording only (which does include the connection and disconnection); 93226 for the scanning analysis and report, and then 93227 for the physician review and interpretation. 

With new devices now capable of longer-term recording and pictured on the right below, the CPT updates for 2021 have included two new sets of codes to capture those monitoring services.  Code range 93241-93244 is for recordings that are greater than 48 hours and up to 7 days.  The second code range spans 93245-93248 and is for external ECG recording for more than 7 days up to 15 days.  Both of these sets of codes are set up in the same manner as the initial Holter monitor codes, with one comprehensive code covering the entirety of the service, and then additional codes which break the service down into its components if an entity or provider only provides a specific component of the service. 

The big take-away here is that while the same information is being collected in each service, the difference is over what time period the data collection is taking place.  Coding professionals must be attentive to that distinction in order to ensure the correct code assignment is made.

Source: https://seekingalpha.com/article/4248365-irhythm-technologies-inc-growth-reversal-will-leave-investors-heartbroken

Now, light has been shed on cardiovascular monitoring services.


About the Author 
Dianna Foley, RHIA, CHPS, CCS  is OHIMA's Coding Education Coordinator. Dianna has been an HIM professional for 20 years. She progressed through the ranks of coder, department supervisor, and department director, to her current role as a coding consultant. 

She recently served as the program director for Medical Coding and HIT at Eastern Gateway Community College. Dianna earned her bachelor's degree from the University of Cincinnati subsequently achieving her RHIA, CHPS, and CCS certifications. She is an AHIMA Approved ICD-10-CM/PCS Trainer and a a presenter at regional HIM meetings and the OHIMA Annual Meeting.