Can someone clarify for me if when we are reporting for the remote pacemaker checks if we are to report the date the check or interp was done or since the codes are only allowed once every 30 days on day 31, that we would wait and report them both for the 31st day's date of service? If the patient was seen on 11/8/22 and then read by the provider on 11/22/22 but the last check was billed 10/10/22 would we report for 11/10/22 since that would have been day 31 or would we bill them for the dates they were actually performed/read?
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Wiki Remote Pacemaker/ICD Checks
- Thread starter tatumroe
- Start date
thomas7331
Guest
The frequency limitations on these codes are a payer reimbursement requirement, not a coding guideline.You have to report the dates that match what is documented in the patient's record as to when the services were performed. Altering the dates to get payment would be a false claim.
If your providers are not doing the interpretations timely, or if the office is not correctly scheduling the patients for intervals greater than the required number of days, then you'll need to educate them that this will cause denials that you, as a coder, have no control over. Or if the provider recommends that the test be performed earlier than the coverage requirements allow for, then an ABN may be obtained if the patient chooses to go ahead with the test and is willing to accept responsibility for payment.
If your providers are not doing the interpretations timely, or if the office is not correctly scheduling the patients for intervals greater than the required number of days, then you'll need to educate them that this will cause denials that you, as a coder, have no control over. Or if the provider recommends that the test be performed earlier than the coverage requirements allow for, then an ABN may be obtained if the patient chooses to go ahead with the test and is willing to accept responsibility for payment.
Last edited:
AmandaBriggs
Expert
I agree with what Thomas stated above. You may find this MLN Matters article helpful as well as it discusses dates of service (cardiovascular monitoring is on page 6): https://www.cms.gov/Outreach-and-Ed...-MLN/MLNMattersArticles/Downloads/SE17023.pdf
lgardner
Guest
This is a nifty document!!
thanks for sharing, Amanda!
AmandaBriggs
Expert
You're welcome 
mquiroz
Contributor
I have an additional question regarding the remote checks. Specifically about the ICDs and the different remote services, such as 93295 and 93297. I know 93295 can be done once every 90 days while 93297 can be reported once every 30 days. My question is , when performed, are we able to report/ bill 93295 on a different day , in between interrogations of the physiologic monitoring system (93297) ? I appreciate your time and help