Cardiology Coding Alert
Remember 30 Day Rule for 93272
Question: We report 93270 and 93272 to Medicare for the first day. We then report 93272 for subsequent days when the patient has an event. Why is Medicare denying the subsequent claims?
Codify Subscriber
Answer: Codes 93270 (External patient and, when performed, auto activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attended monitoring; recording [includes connection, recording, and disconnection]) and 93272 (…transmission and analysis) each cover up to 30 days of service. In other words, reporting the code a single time covers all services performed on a single day and the following 29 days.
Many payer policies help in explaining why these codes apply for up to 30 days. For instance, CGS LCD L31858 states, “Cardiac event detection is a 30-day packaged service. Tests may not be billed within 30 days of each other, even if the earlier of the tests was discontinued when arrhythmias were documented and the patient is now reconnected for follow-up of therapy or intervention.” Novitas L32679 and Cahaba L30038 provide similar information. (To review the LCDs, search each Document ID at www.cms.gov/medicare-coverage-database/.)
Cardiology Coding Alert
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