Cardiology Coding Alert

Question: My cardiologist performed a 93293 service. What are the rules for the monitoring period of this code?

Hawaii Subscriber

Answer: The service you mention is 93293 (Transtelephonic rhythm strip pacemaker evaluation(s) single, dual, or multiple lead pacemaker system, includes recording with and without magnet application with analysis, review and report(s) by a physician or other qualified health care professional, up to 90 days).

The rules: You should not report codes 93293 through 93296 (Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead pacemaker system, leadless pacemaker system, or implantable defibrillator system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results) if the monitoring period is less than 30 days, according to the CPT^® guidelines.

Additionally, you should report codes 93293-93296 only once per 90 days when the physician performs both face-to-face interrogation and remote interrogation during the same time period. Report only the remote interrogation (once per 90-day period) when both are performed.

Do not report code 93293 if the physician performs the evaluation face-to-face instead of remotely. Report a rhythm strip (93040-93042) for a face-to-face evaluation.

Caution: Never report 93293 in conjunction with 93294 (Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead pacemaker system, or leadless pacemaker system with interim analysis, review(s) and report(s) by a physician or other qualified health care professional).

93293 explained: In a 93293 service, the physician evaluates either a single, dual or multiple lead pacemaker system by rhythm strip over the telephone. The cardiologist reviews the pacemaker data and confirms the function of each of the leads, battery, capture, and sensing by transtelephonic monitoring strip once without the magnet and then again with the magnet over the pacemaker. The cardiologist assesses the pacemaker’s function and the time interval to the next analysis, including the review and report of the pacemaker system.

Bonus: Medicare has national guidelines, so please review CMS, NCD for Cardiac Pacemaker Evaluation Services (20.8.1) and CMS, NCD for Transtelephonic Monitoring of Cardiac Pacemakers (20.8.1.1), says Christina Neighbors, MA, CPC, CCC, Coding Quality Auditor for Conifer Health Solutions, Coding Quality & Education Department, and member of AAPC’s Certified Cardiology Coder steering committee. Also, you should review the Heart Rhythm Society FAQs for Cardiovascular Device Monitoring: Implantable and Wearable Devices, HRS Website.