Cardiology Coding Alert

Question: Our physicians are investigating doing reads for another company that supplies the monitors, and we would merely be doing the reading and interpretation. The monitoring company told us to use 93799-26. Is this the proper code for the service provided? I was told that that procedure is by report only.

Maine Subscriber

Answer: If you are referring to a 30-day cardiac event monitor, then 93799-26 (Unlisted cardiovascular service or procedure; professional component) is incorrect. You should use 93272 (Patient demand single or multiple event recording with presymptom memory loop, 24-hour attended monitoring, per 30-day period of time; physician review and interpretation only). Remember to report 93272 only once for up to 30 days and not multiple charges, regardless of the reads.

If your cardiologist means a telemetry-at-home device, which is not an event monitor but a live, real-time patient monitoring at home, however, then some carriers do require 93799, while other payers will require the Holter monitor codes (93224-93233) appended with modifier 22 (Unusual procedural services) because the technology is so new.