How To Use CPT Code 93225

CPT 93225 refers to the external electrocardiographic recording up to 48 hours by continuous rhythm recording and storage, specifically the recording portion of the test. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 93225 procedures.

1. What is CPT 93225?

CPT 93225 is a medical billing code used to describe the recording portion of an external electrocardiographic (ECG) test, which monitors a patient’s heart rhythm for up to 48 hours. This code is used by medical professionals to bill for the service of connecting, recording, and disconnecting the ECG device during the test.

2. 93225 CPT code description

The official description of CPT code 93225 is: “External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; recording (includes connection, recording, and disconnection)”.

3. Procedure

1. The physician or other qualified healthcare professional evaluates the patient and determines the need for an ECG recording.
2. The provider instructs the patient on how to use the external ECG recorder.
3. ECG electrodes are placed on the patient’s chest by the provider.
4. The patient wears the lightweight recorder on a belt for up to 48 hours while going about their normal activities.
5. The device continuously monitors and records the patient’s heart rhythm during this time.
6. After the recording period, the patient returns to the provider, and the device is removed.
7. The recorded data is downloaded onto a computer and analyzed by the provider or other qualified healthcare professional.
8. The provider compiles and prints relevant data and arrhythmias, along with the patient’s logged diary events, and interprets the results.

4. Qualifying circumstances

Patients who are eligible to receive CPT code 93225 services are those experiencing symptoms or conditions that may indicate abnormal heart rhythms, such as palpitations, dizziness, or syncope. The test may also be used to monitor the effectiveness of medications or other treatments for heart rhythm disorders. A physician or other qualified healthcare professional must determine the need for the ECG recording based on the patient’s medical history, symptoms, and physical examination findings.

5. When to use CPT code 93225

It is appropriate to bill the 93225 CPT code when the recording portion of an external ECG test is performed. This includes the connection of the ECG electrodes to the patient’s chest, the recording of the patient’s heart rhythm for up to 48 hours, and the disconnection of the device after the recording period. The code should not be used for the scanning analysis, report, or physician review and interpretation of the test results, as these services are billed separately using different CPT codes.

6. Documentation requirements

To support a claim for CPT 93225, the following information should be documented in the patient’s medical record:

• Indication for the ECG recording, such as symptoms or conditions suggesting abnormal heart rhythms
• Date and time of the ECG recording initiation and completion
• Details of the ECG electrode placement and device connection
• Patient instructions provided for using the ECG recorder and maintaining a diary of events during the recording period
• Confirmation of the device removal and data retrieval after the recording period

7. Billing guidelines

When billing for CPT code 93225, it is important to follow payer-specific guidelines and rules to avoid delays and rebilling. Some insurers may require the use of modifier 59, Distinct procedural service, to separate component codes 93226 and 93227 from 93224. Documentation must support the procedure(s) as separate, distinct procedures, and other modifiers may be more appropriate. Check with the payer to determine the correct date of service, as Medicare generally requires billing services for the date on which the provider performs them.

8. Historical information

CPT 93225 was added to the Current Procedural Terminology system on January 1, 1990. The code has undergone changes in its descriptor over the years, with the most recent change occurring on January 1, 2011.

9. Similar codes to CPT 93225

Five similar codes to CPT 93225 and how they differentiate are:

1. CPT 93224: This code includes all components of a Holter monitor, such as connection, scanning analysis, report, and physician review and interpretation.
2. CPT 93226: This code is used for the scanning analysis and report portion of the ECG test, separate from the recording (CPT 93225) and physician review and interpretation (CPT 93227).
3. CPT 93227: This code is used for the physician review and interpretation of the ECG test results, separate from the recording (CPT 93225) and scanning analysis and report (CPT 93226).
4. CPT 93228: This code is used for external ECG 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 ECG recording for more than 48 hours up to 21 days by continuous rhythm recording and storage, including the scanning analysis and report.

10. Examples

Here are 10 detailed examples of CPT code 93225 procedures:

1. A patient with a history of palpitations and dizziness undergoes a 48-hour ECG recording to evaluate for possible arrhythmias.
2. A patient with a recent diagnosis of atrial fibrillation has a 48-hour ECG recording to assess the effectiveness of a newly prescribed antiarrhythmic medication.
3. A patient with a history of syncope undergoes a 48-hour ECG recording to determine if an abnormal heart rhythm is the cause of the fainting episodes.
4. A patient with a family history of sudden cardiac death has a 48-hour ECG recording to screen for potentially life-threatening arrhythmias.
5. A patient with a known heart rhythm disorder has a 48-hour ECG recording to monitor the stability of their condition and guide treatment decisions.
6. A patient with chest pain and a normal resting ECG undergoes a 48-hour ECG recording to evaluate for possible exercise-induced arrhythmias.
7. A patient with a pacemaker has a 48-hour ECG recording to assess the device’s function and ensure appropriate pacing of the heart.
8. A patient with a history of heart failure has a 48-hour ECG recording to monitor for arrhythmias that may contribute to worsening symptoms.
9. A patient with a history of ventricular tachycardia undergoes a 48-hour ECG recording to evaluate the effectiveness of an implanted cardioverter-defibrillator (ICD) in preventing life-threatening arrhythmias.
10. A patient with a history of supraventricular tachycardia has a 48-hour ECG recording to assess the need for further treatment, such as medication adjustments or ablation therapy.