Cardiology Coding Alert

Question: Can you explain the CPT^® guidelines for new code 93264?

North Dakota Subscriber

Answer: CPT^® offers very specific instructions for how to report new code 93264 (Remote monitoring of a wireless pulmonary artery pressure sensor for up to 30 days, including at least weekly downloads of pulmonary artery pressure recordings, interpretation(s), trend analysis, and report(s) by a physician or other qualified health care professional). Take a look at these rules:

• Rule 1: You should report 93264 only once every 30 days.
• Rule 2: You should not report 93264 if downloads, interpretations, trend analysis, and reports do not occur at least weekly during this 30-day period.
• Rule 3: You should not report 93264 if there is not at least a weekly review during this 30-day period.
• Rule 4: You should not report 93264 if the monitoring period is less than 30 days.

Implantable wireless pulmonary artery sensors explained: “This is a sensor that is implanted into the  pulmonary artery to monitor the pressure in the patient’s pulmonary artery and their heart rate,” Carol Hodge, CPC, CDEO, CCC, CEMC,  certified medical coder at St. Joseph’s Cardiology in Savannah, Georgia explains. “Studies have shown this is a way to monitor the status of a patient’s heart failure allowing physicians to intervene quickly when problems arise and may result in decreased inpatient admissions for control of heart failure.”

Hodge further adds, “The sensor transmits data through a bedside electronic unit. The code requires at least weekly downloads of the pulmonary artery pressure recordings, interpretation, trend analysis and report.