I am looking for some documentation advice for cardiac device monitoring.
For instance, we do remote device monitoring. We have an RN that bills the technical portion (93296) Interrogation device evaluation(s) (remote), up to 90 days; single, dual or multiple lead pacemaker system or implantable defibrillator system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results and then our Cardiologist bills the professional portion (93294) Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead pacemaker system with interim analysis, review(s) and report(s) by a physician or other qualified health care professional.
The documentation to support 93296 is great. We have a flow sheet that is filled out by the RN. The physician feels that it is enough to simply look at the documentation on the flow sheet and make it as reviewed by her (reviewed is a stamp in the EHR, electronically signed in another option). I have explained that this is not sufficient for supporting the billing of 93294 or 93295 (similar description to 93294 but for implantable defibrillator). She is insisting the no other physician is doing additional documentation for 93294 or 93295. The RN claims she has worked for device companies and none of the clinicians she has dealt with did the additional documentation either.
I did find this in an CMS Article for cardiac device monitoring but the MD and the RN are still insisting that this much documentation is not necessary: “the physician performing the review, analysis and report must generate his/her own interpretation and report (with signature) and not just countersign the technical review and distribution of results.” The problem is this article doesn't include code 93294 but I have to believe that if 93295 is on there then 93294 should be. Either way, I would like to follow a consist documentation standard for these services to ensure we are supporting the code.
Does anyone else have some concrete, written information that supports my claim of needing additional documentation (more than looking at the flow sheet and marking it as reviewed)?
For instance, we do remote device monitoring. We have an RN that bills the technical portion (93296) Interrogation device evaluation(s) (remote), up to 90 days; single, dual or multiple lead pacemaker system or implantable defibrillator system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results and then our Cardiologist bills the professional portion (93294) Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead pacemaker system with interim analysis, review(s) and report(s) by a physician or other qualified health care professional.
The documentation to support 93296 is great. We have a flow sheet that is filled out by the RN. The physician feels that it is enough to simply look at the documentation on the flow sheet and make it as reviewed by her (reviewed is a stamp in the EHR, electronically signed in another option). I have explained that this is not sufficient for supporting the billing of 93294 or 93295 (similar description to 93294 but for implantable defibrillator). She is insisting the no other physician is doing additional documentation for 93294 or 93295. The RN claims she has worked for device companies and none of the clinicians she has dealt with did the additional documentation either.
I did find this in an CMS Article for cardiac device monitoring but the MD and the RN are still insisting that this much documentation is not necessary: “the physician performing the review, analysis and report must generate his/her own interpretation and report (with signature) and not just countersign the technical review and distribution of results.” The problem is this article doesn't include code 93294 but I have to believe that if 93295 is on there then 93294 should be. Either way, I would like to follow a consist documentation standard for these services to ensure we are supporting the code.
Does anyone else have some concrete, written information that supports my claim of needing additional documentation (more than looking at the flow sheet and marking it as reviewed)?