Cardiology Coding Alert

Question: Can you explain to me what cardiac event monitors are and which procedure code I should look to if my cardiologist performs the complete cardiac event monitoring service?

Pennsylvania Subscriber

Answer: Cardiac event monitors record segments of electrocardiogram (ECGs) activated by either the patient’s symptoms or by an internal automatic, pre-programmed detection algorithm - or both. The devices “then transmit the recorded electrocardiographic data when requested (but cannot transmit immediately based upon the patient or algorithmic activation rhythm),” according to the CPT^® guidelines.

CPT^® Assistant Vol. 21, No 10 offers even more explanation about these event recorders, “which are electrocardiographic rhythm-derived” by saying that they “include pre-symptom ‘memory loop technology’ for heart rhythm transmissions, which provide physicians with a rhythm strip of a patient’s cardiac rhythm ‘prior’ (presymptom), and/or ‘subsequent’ (postsymptom) to the symptoms that prompted the patient to activate the device.”

Code 93268: You should report global code 93268 (External patient and, when performed, auto activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attended monitoring; includes transmission, review and interpretation by a physician or other qualified health care professional), representing both the technical and professional parts of the service, when your cardiologist performs the complete cardiac event monitoring service.

Code 93268 includes the hookup, recording monitoring, receipt of transmission, disconnection, and the reviewing physician’s interpretation of the rhythm strips and a prepared report, per CPT^® Assistant Vol. 21, No 10.