Cardiology Coding Alert

Question: Which date(s) of service should I report for 30-day cardiac event monitoring?

Washington Subscriber

Answer: For Noridian Medicare, your Part B administrator for Washington, you'll need to know both (1) the date the staff hooked up the patient and (2) the day they disconnected the patient. But knowing which dates to report is only half the battle -- you also need to know where to report them. When you're reporting 30-day cardiac event monitoring, Noridian requires providers to report the hook-up date as the "from" date and the disconnect date as the "through" date in Item 19 of the CMS-1500 (or its electronic equivalent).

Watch out: You should report only the "from" date (that is, the hook-up date) in Item 24A (or its electronic equivalent), Noridian instructs. You should not report the "through" (disconnect) date in 24A because if you have dates spanning two months and only a single unit, "the system inappropriately suspends the claim and asks the provider for clarification," Noridian states.

The codes for 30-day monitoring include 93268-93272 (Wearable patient activated electrocardiographic rhythm derived event recording with presymptom memory loop, 24-hour attended monitoring, per 30 day period of time ...) and 93012-93014 (Telephonic transmission of postsymptom electrocardiogram rhythm strip[s], 24-hour attended monitoring, per 30 day period of time;...).

Or if the "monitoring service meets the definition of the new 30-day cardiovascular telemetry service," look to 93228- 93229 (Wearable mobile cardiovascular telemetry with electrocardiographic recording, concurrent computerized real time data analysis and greater than 24 hours of accessible ECG data storage [retrievable with query] with ECG triggered and patient selected events transmitted to a remote attended surveillance center for up to 30 days ...),Noridian states.

Learn more: You can read more from Noridian in Medicare B News, Issue 253, published April 15, 2009. Head to www.noridianmedicare.com/p-medb/news, and under "Publications," choose "Bulletins" and then Issue 253. Then click on "Cardiac Event Monitoring Codes Billing Clarification -- Revised." Other payers may have a different preference, so be sure to check with them and get the preference in writing.

You Be the Coder and Reader Questions prepared with the assistance of Jim Collins, CCC, CPC, CHCC, president of CardiologyCoder.Com.