Cardiology Coding Alert

Question: What is the code for an event monitor? What is the difference between a Holter monitor and an event monitor?

Kansas subscriber

Answer: There are two types of monitors: the older non-looping recorders (93012-93014) and looping recorders (93268-93272), which include global, recording, monitoring and interpretation services.

For an event monitor, you should report 93268 (Patient demand single- or multiple-event recording with presymptom memory loop, 24-hour attended monitoring, per 30-day period of time; includes transmission, physician review and interpretation).

You'll also find codes for recording (93270, ... recording [includes hook-up, recording, and disconnection]), monitoring (93271, ... monitoring, receipt of transmissions, and analysis), and interpretation and report (93272, ... physician review and interpretation only).

Beware: If the patient undergoes monitor recording for less than the 24-hour/30-day monitoring, you should report the unlisted-procedure code (93799, Unlisted cardiovascular service or procedure) rather an event monitoring code with modifier 52 (Reduced services).

Difference: An event monitor can typically record multiple events (when the patient cues it to) over several days. A patient usually only wears a Holter monitor for 24-48 hours and records the entire time he is wearing it.

Cardiologists use cardiac event monitoring, sometimes confused with Holter monitoring, to detect heart arrhythmias. The physician may put a patient on a cardiac event recorder if he is discharged from the hospital after a myocardial infarction, or is on antiarrhythmic medications, or if his chest pain is difficult to diagnose. The patient is given a special ECG machine that allows him to record events at home and transmit data over the telephone to a central processing unit, which produces a printout of the data for physician interpretation.