Advanced Search

Cardiology Coding Alert

Reader Question:

Holter Monitoring

Published on Mon Apr 01, 2002

Question: Our cardiologist interpreted data from a 24-hour Holter monitor. Should I append modifier -26 to 93224?

Florida Subscriber
 
Answer: Modifier -26 (Professional component) should not be appended to 93224 (Electrocardiographic monitoring for 24 hours by continuous original ECG waveform recording and storage, with visual superimposition scanning; includes recording, scanning analysis with report, physician review and interpretation), because CPT already lists a separate code for this service (93227, physician review and interpretation).
 
If the cardiologist reviewed and interpreted the data but does not own the equipment, 93227 should be reported.
 
It is not always easy to know when modifier -26 applies. The easiest way to be sure is to look up the code in the fee schedule.
 
Codes that require modifier -26 for the cardiologists interpretations are listed three times: The code is listed first (called the global code because it includes both the professional component and the technical component, which is designated by appending modifier -TC), with the technical and professional components then listed separately.
 
If a code is listed only once, modifier -26 (or modifier -TC) should not be appended.
 
Much the same as stress tests and echocardiograms, however, Holters include multiple components, each of which is reported using a different code.
 
Holter monitoring has three components: In addition to the global code (93224) and the supervision and interpretation code (93227), other components are reported using 93225 ( recording [includes hook-up, recording, and disconnection]) and 93226 ( scanning analysis with report).
 
Relative value units (RVUs) are divided as follows: global code 93224, 4.2 RVUs; 93225, 1.25; 93226, 2.2; 93227, 0.75.

Other Articles in this issue of

Cardiology Coding Alert

View All