Cardiology Coding Alert

Question: Is there a list of payable diagnoses for tilt table testing?

Alabama Subscriber

Answer: Most Medicare carriers consider only one diagnosis, syncope (780.2), acceptable for tilt-table tests (93660, evaluation of cardiovascular function with tilt table evaluation, with continuous ECG monitoring and intermittent blood pressure monitoring, with or without pharmacological intervention), notes Terry Fletcher, BS, CPC, CCS-P, a cardiology coding and reimbursement specialist in Laguna Beach, Calif.

WPS Health Services, the local Medicare carrier in Illinois, Michigan, Minnesota and Wisconsin, however, accepts the following eight ICD-9 codes as well:

337.0 idiopathic peripheral autonomic neuropathy

337.1 peripheral autonomic neuropathy in disorders classified elsewhere

352.3 disorders of pneumogastric [10th] nerve

458.0 orthostatic hypotension

458.1 chronic hypotension

458.8 other specified hypotension

458.9 hypotension, unspecified

780.4 dizziness and giddiness.

Alabama Medicare, which is administered by Blue Cross Blue Shield of Alabama, has not published any guidelines for tilt table testing. It likely accepts the syncope diagnosis because in a published policy on implantable loop recorders (ILRs) it allows the placement of an ILR in patients who have had syncopal episodes but could not be diagnosed using the tilt table.