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Thread: BIlling for 48 hour Holer

  1. #1

    Question BIlling for 48 hour Holer

    AAPC: Back to School
    We have just started billing for Holter monitors. We own the equip and do the readings so we are billing 93224 for the 24 hour.

    What do we bill for the 48 hour? Do we bill 93224 for day one and 93226,93227 for day 2?

    Any help would be great...thanks!

  2. #2
    Join Date
    Apr 2007

    Default Not an official source but some good ideas.

    I wasn't able to find any official resource information but did locate an unofficial sorce that advised the following options...

    [1] Add modifier -22 to procedure code 93224 and increase your fee based on your provider's protocol. Be certain to include documentation to justify the prolonged service.

    [2] Consider reporting 93224 on two separate lines with the appropriate date on each line.

    [3] Another sorce advised reporting 93224 on the first line and 93237 on the seoncd line for the second 24 hour period. Their rational is that many services performed for the 24-hour Holter do not need to be reproduced for an additional 24 hours.

    I highly recommend contacting the carrier to determine how they would prefer to see the service reported.

  3. #3
    Join Date
    Apr 2007

    Default 48 Hr Holter Monitor

    We are currently having the same debate and have come up with the same information. Has anyone out there come up with something more definitive since this thread was started? We tried to get clarification from the payer on how they wanted the service keyed but they "do not have anyone who can answer coding questions.

    Any input is appreciated

  4. #4
    Join Date
    Apr 2007
    Duluth, Minnesota


    We always used the 93224 with two dates - the initial date of course - and the day after for the next one. That worked best and didn't seem to cause any issues. If it was Medicare however - we used 93225tracing/93227interp - with two dates of course.
    Donna, CPC, CPC-H

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