Cardiology Coding Alert

Learn to report only the services your cardiologist actually performed

When you're preparing to report cardiac monitoring, you need to keep one important thing in mind: You must differentiate cardiac monitoring technologies in order to ascertain which set of codes you should use.

Which codes you'll report depends on three kinds of technologies: visual superimposition scanning, microprocessor analysis, and patient-activated event markers. 93224-93227 = Visual Superimposition Scanning You will most commonly report 93224-93227 for the monitoring services your cardiologist performs. Within this set, 93224 (Electrocardiographic monitoring for 24 hours by continuous original ECG waveform recording and storage, with visual superimposition scanning; includes recording, scanning analysis with report, physician review and interpretation) is the global code, while each of the subsequent three codes describes separate slices of the overall service, such as, 93225 (... recording [includes hook-up, recording, and disconnection]), 93226 (... scanning analysis with report), and 93227 (... physician review and interpretation).

Use these four codes to report services that specially trained technicians perform to visually scan patient waveforms generated by the monitor. The waveforms are then compared with a normal waveform to identify discrepancies.

Here's another key to success - you should only report the services your cardiologist actually provided. If your cardiologist performed all of the described services, which include hooking up and removing the monitor, analyzing the scan, and reviewing and interpreting the results, you should report the first code in the series (such as, 93224).

You should use this code because it encompasses all of the procedure's components, says Lisa Center, CPC, quality review coordinator for Freeman Health System in Joplin, Mo.
 
If the cardiologist performed only some of those services, however, you will bill only for the individual services provided.

Note: All three of the extended monitoring tech-nologies break out the individual components separately.

Example: Your office monitored a patient using the equipment described in 93224, but the cardiologist did not do the scanning analysis. You may have an outside company perform that technical component.

In that scenario, you would report 93225 for the recording, hook-up and removal of the cardiac monitor and 93227 for physician review and interpretation. The scanning company would report codes of its own for the analysis.

Heads up: Even if your office is limited to another type of technology, you may find yourself reporting codes from this series when the cardiologist provides the patient with a cardiac device monitor in the hospital.

For example, if your cardiologist interprets information from a visual superimposition scanning cardiac device in the hospital, you'll report his interpretation using 93227, says Kathy Beckette, medical biller at Cardiac Associates of New Hampshire in Concord, N.H. 93230-93233 = Microprocessor Analysis The second set of extended EKG monitoring codes within the series 93230-93233 does [...]