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Mobile Cardiac Outpatient Telemetry

  1. Question Mobile Cardiac Outpatient Telemetry
    Medical Coding Books
    Our office has recently been solicited by Cardionet concerning the Mobile Cardiac Telemetry Holter Monitors, we have some concerns regarding the billing of these services.
    Medicare guidelines state to use the unlisted code of 93799-26 with only one unit to be billed. Yet, Cardionet states for commerical carriers we are to bill 93237 with multiple units, except for Aetna who we are to bill with the S0347 with only one unit to be billed. My concerns lies in three different codes the same service and the issue of units, if Medicare states "one unit only" how could it be correct to bill multiple units for the other carriers. Not to mention the billing concerns on the patient side when two different EOB's arrive for this service. My apologies if this is a basic question to some of you experience coders out there , but I am in a learning curve here and I have ethical and legal concerns in this area of billing.
    Tami Rand, C.P.C.
    Fort Worth Heart, P.A.
    Fort Worth, Tx

  2. #2
    Unhappy
    Quote Originally Posted by RAND View Post
    Our office has recently been solicited by Cardionet concerning the Mobile Cardiac Telemetry Holter Monitors, we have some concerns regarding the billing of these services.
    Medicare guidelines state to use the unlisted code of 93799-26 with only one unit to be billed. Yet, Cardionet states for commerical carriers we are to bill 93237 with multiple units, except for Aetna who we are to bill with the S0347 with only one unit to be billed. My concerns lies in three different codes the same service and the issue of units, if Medicare states "one unit only" how could it be correct to bill multiple units for the other carriers. Not to mention the billing concerns on the patient side when two different EOB's arrive for this service. My apologies if this is a basic question to some of you experience coders out there , but I am in a learning curve here and I have ethical and legal concerns in this area of billing.
    Tami Rand, C.P.C.
    Fort Worth Heart, P.A.
    Fort Worth, Tx

    We are having the same discussion here, a cardionet representative called our office this week, and we are now trying to find guidelines for billing this service. It also seems strange to me that there are different codes for different carriers. Any guidance anyone out there has in regard to this subject would be greatly appreciated.
    Billie Jo Kraft, CPC
    Wyoming Cardiopulmonary Services, PC

  3. #3
    Default Cardionet
    We are having the same discussion here in Tennessee. As of this time, we are not billing.

    L. White, RN, CPC

  4. #4
    Default
    I've been having a hard time getting paid by Medicare. I've billed it exactly how the rep informed me (cms form block 19 i have to write mobil cardial outpatient telemetry-cardionet) and medicare after receiving the claim are wanting the documentation which I've already submitted wanting for a reply.

    the rep informed me that you only bill the last day.

  5. Default
    Quote Originally Posted by ortega831 View Post
    I've been having a hard time getting paid by Medicare. I've billed it exactly how the rep informed me (cms form block 19 i have to write mobil cardial outpatient telemetry-cardionet) and medicare after receiving the claim are wanting the documentation which I've already submitted wanting for a reply.

    the rep informed me that you only bill the last day.
    I just started in a cardiology office and the Nurse Practitioner just showed me a pile of these that she has yet to bill for. Is anyone having any luck yet?

  6. Default
    Medicare guidelines? We too have been contacted by the lovely Cardionet and have been told so many things I'm not sure how to go about billing this. Where did you find the Medicare guidelines? I called Noridian (I am in AZ) and asked about billing this. I was not told to bill with the unlisted procedure I was under the understanding from that call that we could bill Medicare with the 93237 as well.

    Ughh, how many grey hairs do I have now?

  7. #7
    Question Cardionet
    Hello there we too have just started billing for this serive. There is a lot of differences and explanations regarding billing.
    I have been told that if you submit the documention to medicare after billing 93799/26 with detailed description in box 19 (mobile cardiac outpatient telemetry) with the start date only and only one unit.

    However, starting in 2009 there is a code available that will eliminate the unlisted code.

    As far as BCBS and Aetna we were told to use S0347 per day and authorization is needed prior too beginning service.

    Cigna and Anthem state they reimburse per day using 93237 (which is not the correct code).

    So, there is much controvery surrounding this issue. so, if anyone has any additional billing information I would be grateful.
    Thanks
    Delina Thomas-Nieforth, CPC, CPC-I

  8. Default
    We are having the exact problem here too. I've done excatly what the reps told us, used the unlisted code for MCR, wrote the decription in 19, attached the report and no luck. Latest was to use the HCPCS code but now they don't want that anymore. I just spoke with the rep but all they can tell me is that for 2009there is a new code, which doen't help me in getting these 08 paid.

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