Lburbridge
New
I am seeking compliant billing and coding guidance related to concurrent remote monitoring of a dual-function cardiac implanted device (pacemaker with ICM functionality).
In this scenario, we are billing:
During a 90-day monitoring cycle, both a 30-day review and a 90-day review were completed. We have supporting documentation demonstrating that:
The question is whether it is appropriate to report both codes in the third month when both services were performed and documented.
We have reviewed applicable NCDs, LCDs, NCCI edits, CMS guidance, and MAC resources and have not identified explicit language prohibiting billing these codes together when documentation supports separate services.
We are looking for guidance, published documentation, or authoritative references that address whether concurrent billing in this scenario is compliant.
Thank you in advance for your insight.
In this scenario, we are billing:
- 93296 – Remote interrogation device evaluation (technical component)
- 93297-TC – Remote physiologic monitoring (technical component only, as this is a purchased diagnostic service from a vendor and cannot be billed globally)
During a 90-day monitoring cycle, both a 30-day review and a 90-day review were completed. We have supporting documentation demonstrating that:
- The services were separate and distinct
- Medical necessity was met
- Reviews were completed and signed by the appropriate clinical staff
The question is whether it is appropriate to report both codes in the third month when both services were performed and documented.
We have reviewed applicable NCDs, LCDs, NCCI edits, CMS guidance, and MAC resources and have not identified explicit language prohibiting billing these codes together when documentation supports separate services.
We are looking for guidance, published documentation, or authoritative references that address whether concurrent billing in this scenario is compliant.
Thank you in advance for your insight.