Wiki How often can you bill 93279-93292?

[jazzyblues2005]

Hi,

I've recently started coding cardiology, mainly pacemakers and ICDs. I have been researching information on the correct way to code and bill the device checks. However, I can't seem to find anything in regards to the codes listed in my title. Does anyone know if there is a set guideline? I know the remote codes vary from 30-90 days. Does anyone know of any links or articles?

Anything would be helpful,
Thanks!
Diana

 

[jewlz0879]

I just covered this in July's article for The Coding Leader, in their Cardiology Coding Advisor piece. Aside from the 30 or 90 day "rule," Medicare has established national guidelines indicating normal frequency. See below:

Single Chamber PM - Guideline I
1st month - every 2 weeks
2nd thru 36th month - every 8 weeks
37th month to failure - every 4 weeks

Dual Chamber PM
1st month - every 2 weeks
7th thru 36th month - every 8 weeks
37th month to failure - every 4 weeks

You can ck these out @:

CMS, NCD for Cardiac Pacemaker Evaluation Svcs (20.8.1), 10/01/1984
NCD for Transtelephonic Monitoring (20.8.1.1), 10/03/03

HTH

 

[ccollison]

We have been fighting our Medicare carrier on this issue for a while. The Medicare policy that Judy cited allows monitoring frequency based on the age of the generator, but they just won't pay for monitoring any more than every 90 days. Often, our pacemaker checks are free. So frustrating!