How To Use CPT Code 93224

CPT 93224 is a code used for external electrocardiographic recording up to 48 hours by continuous rhythm recording and storage, including recording, scanning analysis with report, review, and interpretation by a physician or other qualified health care professional. This article will cover the description, procedure, qualifying circumstances, when to use the code, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 93224 procedures.

1. What is CPT 93224?

CPT 93224 is a medical billing code used to describe a specific type of external electrocardiographic (ECG) recording procedure. This procedure involves continuous rhythm recording and storage for up to 48 hours, and includes the recording, scanning analysis with report, review, and interpretation by a physician or other qualified health care professional.

2. 93224 CPT code description

The official description of CPT code 93224 is: “External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; includes recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional.”

3. Procedure

1. The provider instructs the patient on the use of an external ECG recorder.
2. ECG electrodes are placed on the patient’s chest, connected to a small lightweight recorder or monitor worn by the patient on a belt.
3. The device records the heart’s electrical activity by continuous rhythm recording and storage for up to 48 hours while the patient goes about their normal activities.
4. After 48 hours, the provider removes the device and downloads the data onto a computer.
5. The provider performs a scanning analysis, compiles and prints the relevant data and arrhythmias, along with the patient’s logged diary events, and interprets the results.

4. Qualifying circumstances

Patients eligible to receive CPT code 93224 services are those who require continuous monitoring of their heart’s electrical activity for up to 48 hours. This may include patients with symptoms suggestive of cardiac arrhythmias, such as palpitations, dizziness, or syncope, or those with a history of cardiac events or conditions that may predispose them to arrhythmias. The provider must determine that this specific type of ECG monitoring is medically necessary for the patient’s condition.

5. When to use CPT code 93224

It is appropriate to bill the 93224 CPT code when a provider performs an external electrocardiographic recording for up to 48 hours by continuous rhythm recording and storage, and the procedure includes recording, scanning analysis with report, review, and interpretation by a physician or other qualified health care professional. The provider must determine that this specific type of ECG monitoring is medically necessary for the patient’s condition.

6. Documentation requirements

To support a claim for CPT 93224, the following information should be documented:

• Patient’s medical history and symptoms that justify the need for continuous ECG monitoring.
• Provider’s determination that the 48-hour ECG monitoring is medically necessary for the patient’s condition.
• Details of the procedure, including the placement of electrodes, connection to the recorder, and patient instructions.
• Results of the scanning analysis, including any identified arrhythmias or other relevant findings.
• Provider’s review and interpretation of the results, along with any recommendations for further evaluation or treatment.

7. Billing guidelines

When billing for CPT code 93224, it is important to remember that this code represents both the technical and professional components of the service. Therefore, modifiers 26 (Professional component) and TC (Technical component) should not be appended. If the provider reports only the scanning analysis portion of the test, use CPT code 93226. For the professional component only, use CPT code 93227.

8. Historical information

CPT 93224 was added to the Current Procedural Terminology system on January 1, 1990. Since then, there have been several updates to the code description:

• Code Changed on 01-01-2009: “Electrocardiographic monitoring for 24 hours by continuous original ECG waveform recording and storage, with visual superimposition scanning; includes recording, scanning analysis with report, physician review and interpretation.”
• Code Changed on 01-01-2011: “Wearable electrocardiographic rhythm derived monitoring for 24 hours by continuous original waveform recording and storage, with visual superimposition scanning; includes recording, scanning analysis with report, physician review and interpretation.”
• Code Changed on 01-01-2013: “External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; includes recording, scanning analysis with report, physician review and interpretation.”

9. Similar codes to CPT 93224

Five similar codes to CPT 93224 and how they differentiate are:

1. CPT 93225: This code is used for applying and disconnecting the device and making the recording, but does not include scanning analysis, review, or interpretation.
2. CPT 93226: This code is used for the scanning analysis with report portion of the test only, without the recording, review, or interpretation.
3. CPT 93227: This code is used for the professional component only, which includes the review and interpretation by a physician or other qualified health care professional.
4. CPT 93228: This code is used for external electrocardiographic recording for more than 48 hours up to 21 days by continuous rhythm recording and storage.
5. CPT 93229: This code is used for external electrocardiographic recording for more than 48 hours up to 21 days by continuous rhythm recording and storage, with scanning analysis, report, review, and interpretation.

10. Examples

Here are 10 detailed examples of CPT code 93224 procedures:

1. A patient with a history of palpitations and dizziness undergoes a 48-hour continuous ECG monitoring to evaluate for possible arrhythmias.
2. A patient with a recent myocardial infarction has a 48-hour ECG monitoring to assess for any residual arrhythmias or conduction abnormalities.
3. A patient with a family history of sudden cardiac death undergoes a 48-hour ECG monitoring to screen for any underlying arrhythmias.
4. A patient with recurrent syncope has a 48-hour ECG monitoring to determine if an arrhythmia is the cause of the episodes.
5. A patient with a history of atrial fibrillation undergoes a 48-hour ECG monitoring to assess the effectiveness of a new antiarrhythmic medication.
6. A patient with a known heart block has a 48-hour ECG monitoring to evaluate the need for a pacemaker.
7. A patient with a history of ventricular tachycardia undergoes a 48-hour ECG monitoring to assess the risk of future events.
8. A patient with a recent episode of chest pain and an inconclusive stress test has a 48-hour ECG monitoring to evaluate for possible ischemia.
9. A patient with a history of supraventricular tachycardia undergoes a 48-hour ECG monitoring to assess the frequency and duration of episodes.
10. A patient with a known long QT syndrome has a 48-hour ECG monitoring to evaluate the risk of torsades de pointes or other ventricular arrhythmias.