Wiki new coder needs help coding holter monitor

[ggparker14]

I need help with coding holter monitor. I code for a physician's group that sends their patients to the local hospital to have the test done as OP. The physician from the group will interpret the test and then write up a holter monitor report. How do I code this. I know that my choices are 93224, 93228, 93227 and 93229, but don't really understand the difference in the codes. Can someone explain when I should use 93224 vs 93228 and how to tell the difference as well as the 93227 and the 93229. Any help is appreciated. Thanks.

 

[Lisa Bledsoe]

The difference between 93224 and 93228 is that 93228 (called an "ECAT") is greater than 24 hours. Your physician would not normally report 93229 "technical support and patient instructions...". 93228 is the physician component only.

I believe in your scenario since the patient is getting the holter connected at the hospital you would only report 93227 (physician review and interpretation) on the date of interpretation.

Hope that helps.

 

[ggparker14]

I have a patient that is wearing the monitor for 48 hours, would I need a different code for this particular case. Thank you for your help.

 

[Lisa Bledsoe]

That could be 93228 "greater than 24 hours...for up to 30 days". That's a great questions! I hope someone more experienced than I am will read and respond!!

 

[Jess1125]

If the patient wore the monitor for 48 hours I would think more than likely this patient had a holter monitor on and you would use 93227x2 (the code is per 24 hours)

I don't know what state you are in but I would check your insurance policy.

I'm in Wisconsin and for WPS Medicare the guidelines state to report the code on 2 separate lines. If the patient had the monitor hooked up on December 1st and wore for 48 hours I would report as below:

12/1/10 93227
12/2/10 93227

That will all change, though, come January 1st and the holter monitor description changes and will then say "up to 48 hours monitoring".

Jessica CPC, CCC