Wiki Holter Monitor - allowed to bill this code

[bkrol2012]

Could someone please help me with holter monitor billing. Our practice just recently realized that we have monitors that were not billed. I contacted our company that does the monitors and was given the codes but I'm still confused. I was told that we can bill the 93225 on the day that the monitor is hooked up. Are we allowed to bill this code along with the office visit and an EKG if they are done on the same day as the monitor hook up? I was told to bill 93272 and 93228 once our physician has received the report and read it. I'm confused about these codes are we to bill both codes 93272 and 93228? Are we allowed to bill 93272 to Medicare or just the 93228. I would appreciate all the help that I could get on this matter.

 

[courtcadle]

Our office does holter (24-48hr) monitors but ours are considered 93224. We do all the steps such as hookup, data storage, unhook & physician readings. The is not additional code for 93224 includes reading by physician. (We own these holters/the payment is bundled)

When we do event monitoring (7day) 93270 is billed (DOS: Day it was hooked up). The equipment is sent back to company that retrieves the data off of it. Once the data is back a physician reads it. Code 93272 is then billed (DOS: Day it is read). Since we don't do all the steps of the bundled payment, we only bill for the parts we did. *** These codes should not be reported for the same DOS for they are not performed the same day.

While I know you are using different codes this hopefully give you an idea, how it flows. 93228 is for a remote access kind & physician review/interpretation is included in the payment (would be billed alone - it's a bundle). If you were billing a 93225 then the physician review/interpretation would be billed as 93227. You may want to check & make sure yours doesn't fall under 93224.

Unless the patient is being seen for something else (then just hooking up the holter) you should not be billing an office visit. Also you can not do holters & EKGs on the same DOS. Are patients are homebound so we go to them- we do the EKG when we are picking up the holter since the DOS of the holter is the day before when we dropped it off. Hope that helps some