Part B Insider (Multispecialty) Coding Alert

Published on Tue Mar 28, 2006 PDF

Avoid “reprogramming codes” 93742 and 93744

Did you know that new technology allows doctors to check up on patients’ implanted cardiac defibrillators (ICD) remotely?

The problem: There isn’t one simple way to code this new service. Check out the following possibilities so that you can get to the heart of this coding matter.

How it works: The new technology uses services such as Medtronic’s CareLink to electronically transmit data to a receiving station, where it is stored until the physician can evaluate it. These devices also can transmit an unexpected event, such as discharge from the defibrillator or cardiac arrhythmia, according to Part B carrier Noridian.

What to do: Until there’s a more specific CPT Code, carriers may want you to use 93741 (Electronic analysis of pacing cardioverter-defribrillator [includes interrogation]…) or 93743 (…dual chamber, without programming), says Terri Davis, CPC, CIC, a coding supervisor at The University of Oklahoma College of Medicine in Oklahoma City.

Watch out: Avoid codes with “reprogramming” in their descriptors (like 93742 and 93744), because the analysis of an ICD won’t include any programming. Noridian and others also advise coders not to report this service more than three times per 60-day period unless you have documented a specific medical reason.

If the service your cardiologist provides is comparable to the descriptions for 93741 and 93743, you can report it regardless of where the service took place, whether in the office, over the Internet, or over the phone line, says the Heart Rhythm Society (HRS) in the 2005 Coding Guide for Heart Rhythm Procedures.

Alternative: Some carriers, such as Oklahoma Medicare, prefer another coding route. For remote defibrillator checks, they may request that you report an unlisted-procedure code--specifically, 93799 (Unlisted cardiovascular service or procedure).

Do this: Check with your carriers to see which code(s) they prefer. Ask the device company representative who helps you get set up on the remote monitoring program for documentation from your carrier--that way you won’t have to waste time getting an okay every time you file these claims.