Cardiology Coding Alert

Cardiologists who review data gathered by a non-looping event monitor and report G0016 (Post-symptom telephonic transmission of electrocardiogram rhythm strip[s] and 24-hour attended monitoring, per 30-day period: Physician review and interpretation only) should take note: HCPCS 2002 has deleted G0016 without providing further advice on how interpretation should be billed.
 
Ask your local Medicare Part B carriers whether they have responded to the change and, if so, how those interpretations should be billed.
 
These event monitors are more correctly called "post-symptom" because they do not record constantly and have no memory. Instead, the patient places electrodes on the wrists or fingers when experiencing rapid heartbeats and dials a number that "traces" the event. The cardiologist reviews and interprets the results. The patient may make several transmissions, says Sandy Rubio, RN, CPC, a cardiology coding and reimbursement specialist in Omaha, Neb.
 
Other codes describing non-looping event monitoring that remain in effect include G0015, 93012 and 93014.
 
All the codes (including G0016) have or had a 30-day period. Within that time, Rubio says, the appropriate code may be billed only once no matter how many transmissions were traced, analyzed and reviewed.
 
Note: If the cardiology practice leases but does not own the equipment, tracing (G0015) may not be billed to Medicare carriers.
 
The removal of G0016 complicates coding for these recorders, which until now was relatively straightforward. When a non-looping event recorder on a patient with private insurance was analyzed, 93012 and/or 93014 was used. For Medicare patients, cardiologists billed G0015 and/or G0016.
 
"With G0016 no longer available, the question becomes, how should the interpretation be reported," says Gay Boughton-Barnes, CPC, MPC, CCS-P, a cardiology coding and reimbursement specialist in Tulsa, Okla. "Are we just supposed to include the interpretation in the E/M visit when the cardiologist goes over the findings on the rhythm strip with the patient? Are we supposed to revert back to 93014, the equivalent CPT code? Is Medicare now saying that G0015 should be used to report the whole service, not just the tracing? We just don't know."
 
One local Medicare carrier is advising cardiologists to switch to the CPT code when only an interpretation is provided and to mix HCPCS and CPT codes if tracing and review are performed. Even so, many local medical review policies published before the current change instructed cardiologists never to mix CPT and HCPCS codes for the same service. Trailblazer Health Enterprises (Part B carrier in Texas) instructs cardiologists to report 93014 in place of G0016. If the cardiologist provides the complete service (i.e., tracing and review), G0015 and 93014 should be billed, according to Trailblazer's technical service desk.
Loop Memory Event Monitors
 
The cardiologist documenting services involving an event recorder may, in fact, be referring to a memory loop [...]