Telemedicine Codes Useful for Billing Event Recording
Published on Sun Aug 01, 1999
Telemedicine has experienced rapid growth in recent years, with cardiologists, payers and code writers scrambling to catch up. Most people, physicians and their staff included, tend to view telemedicine as long-distance consults via computer and television screen. But there are several other kinds of telemedicine that cardiologists, in particular, utilize more than most physicians, though they may refer to such services by another name. For example, cardiac monitoring, which CPT refers to as event recording, is a form of telemedicine.
According to John Linkous, executive director of the American Telemedicine Association in Washington, DC, services that fall under the telemedicine category include teleradiology, which allows physicians to store x-rays on diskette and then view results on their computers at home; and monitoring patients in their homes with portable units, such as ECG monitors and pacemakers.
Telemedicine utilization has grown very rapidly. However, so have the regulations regarding its coding and reimbursement, making it difficult for cardiologists to keep up and get paid properly.
A variety of codes already exist for telemedicine, though the descriptions tend to be vague, making it difficult to be certain which one to use. In addition, many cardiologists may be unaware that HCFA has created a new group of HCPCS codes (in the G section) that replace existing CPT codes. In a similar vein, one important CPT code (see below) awaits revision because its description in CPT 1999 is at variance with HCFA regulations, due to the introduction of the G codes.
In short, individuals billing for telemedicine consults of any kind need to understand all the ramifications of the technology and associated coding issues to obtain fair and correct payment for such services.
Currently, says Linkous, the following CPT codes can be used by cardiologists for telemedicine activity involving portable ECGs and pacemakers. These are:
93012- Telephonic transmission of post-symptom electrocardiogram rhythm strip(s), per 30-day period of time; tracing only.
93014- Physician review with interpretation and report only. Codes 93012 and 93014 should be used to report phone transmissions of ECG rhythm strips from patients with old-fashioned patient event recorders that do not incorporate memory loop technology. These codes are used when a physician is interpreting an ECG strip which has been done in a distant area by a physicians assistant or nurse practitioner because no physician is available at the source.
93733- Electronic analysis of dual chamber internal pacemaker system (may include rate, pulse amplitude and duration, configuration of wave form, and/or testing of sensory function of pacemaker), telephonic analysis.
93736- Electronic analysis of single chamber internal pacemaker system (may include rate, pulse amplitude and duration, configuration of wave form and/or testing of sensory function of pacemaker), telephonic analysis.
Another set of codes93268, patient demand [...]
