Wiki Holter monitors - My doctor is doing

[mfaz72]

My doctor is doing a 48 hours holter. How is the 48 hours billed differently than the 24? Or is it?

 

[tkendall]

48 hrs holters

You bill with 2 units. HOWEVER, you need to watch these. Some payers will only pay for a 24hr unless you can prove medical necessity for a 48hr.

 

[deeva456]

we were billing these incorrectly for years, then discovered the correct way to bill for 48 hr holter monitors. the first day you can bill for hookup, scanning, and report. the 2nd day you can bill for scanning and report only. Depending on the type of holter monitor you have depends on which codes to use:
1st 24 hrs: 93230
2nd 24 hrs: 93232

or

1st 24 hrs: 93224
2nd 24 hrs: 93227

 

[jlbridges]

48 hr holter monitor 93224

In a Medicare Article, it states 93224 covers 24 OR the occasional 48 hour monitoring (The CPT book does not have the verbiage "OR 48 hr)
The holter is placed ONCE on the patient, ONE tracing is ran, and ONE interpretation is done; regardless of how long they wear the monitor. So please explain to me, how one can bill for a second 24 hr period with this code set? I feel it's un-bundling

 

[agott]

We use Medtronic to process the data, so in our office for a 48 hour holter monitor we use:
93225: Hook-up with first 24 hour date
93227: with the first 24 hour date
93227; with the second 24 hour date

This was a question that came up at a McVey Cardiology seminar that I attended and Terry Fletcher confirmed that this was the correct way to bill when you dont own your own equipment. Hope that this helps.

Just a FYI also I recentley learned that for every provider in your practice that is a member of the AMA you are allowed 6 free question per year per member. In case you are interested in that and wanted to take note the phone number is 1-800-621-8335.

Autumn CPC
Grand River Cardiology plc

 

[jlbridges]

Autumn,

On the example you have listed, did the patient return on both days, and did the physician read two reports?

 

[agott]

Jean,

The patient does not return to the office both days, just the inital day to be hooked up, record the baseline tracing, and have the forms filled out etc. The report that we get back is one report but clearly notes that it was a 48 monitor and the doctor reviews and interps the report.

Autumn