Cardiology Coding Alert

Reader Question:

Billing for Holter Monitor

Question: In the July 1999 issue of CCA on page 52, it was asked What is the correct date to bill for a Holter monitor? Your answer, when global, is the date the test was initiated. The American College of Cardiology is advising that we bill after the complete service is completed, which means the date of the interpretation. Can you verify?

Savanna Siens, CPC
Northland Cardiology, MO

Answer: Although many cardiology practices bill using the day the test was initiated, ACC guidelines do state that the test should be billed on the date the test was completed, because the procedure includes a professional component, or interpretations, which could not be done by the physician until after the testing is over, says Cynthia Swanson, RN, CPC. If we bill the date we initiated the test, we are billing before we have results or interpretation, she says. Monitoring tests are broken down into three categories: professional (interp), technical, or global. Coding a global test means the cardiologist (or his or her practice) performed both the technical and professional components.

Obviously, if the CPT code says with interp, then
we cant bill for it until the physician reads the results, Swanson says. In other words, a 24-hour test should be dated on the second day, while a 30-day test should be dated on the 30th day.

Although most coders agree that carriers usually arent terribly concerned about the date the service is reported, Swanson notes that if were audited by Medicare, and they want records on the date of service, it should match the date of service on the report. If were putting the interp date on the report, we also should put the interp date on the claim.