How To Use CPT Code 93229

CPT 93229 is a code for external mobile cardiovascular telemetry with electrocardiographic recording, concurrent computerized real-time data analysis, and greater than 24 hours of accessible ECG data storage. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 93229.

1. What is CPT 93229?

CPT 93229 is a medical billing code used for external mobile cardiovascular telemetry with electrocardiographic recording, concurrent computerized real-time data analysis, and greater than 24 hours of accessible ECG data storage. This code is used when a patient requires continuous monitoring of their heart’s electrical activity for an extended period, typically up to 30 days. The data collected is transmitted to a remote attended surveillance center for analysis and reporting.

2. 93229 CPT code description

The official description of CPT code 93229 is: “External mobile cardiovascular telemetry with electrocardiographic recording, concurrent computerized real time data analysis and greater than 24 hours of accessible ECG data storage (retrievable with query) with ECG triggered and patient selected events transmitted to a remote attended surveillance center for up to 30 days; technical support for connection and patient instructions for use, attended surveillance, analysis and transmission of daily and emergent data reports as prescribed by a physician or other qualified health care professional.”

3. Procedure

1. A technician places external electrodes on the patient’s body, which are connected to a wearable electrocardiographic monitoring device.
2. The patient is instructed on how to use the device and how to report any symptoms or events they experience.
3. The device continuously records the patient’s heart’s electrical activity and transmits the data to a remote attended surveillance center via phone signals.
4. Technicians at the surveillance center monitor incoming data, analyze it, and prepare daily and emergent data reports.
5. The reports are transmitted to the prescribing physician or other qualified health care professional for review and further action if necessary.

4. Qualifying circumstances

Patients eligible to receive CPT code 93229 services are those who require continuous monitoring of their heart’s electrical activity for an extended period, typically up to 30 days. This may include patients with a history of cardiac events, those experiencing symptoms suggestive of arrhythmias, or those at risk for developing abnormal heart rhythms. The prescribing physician or other qualified health care professional will determine the need for this service based on the patient’s medical history, symptoms, and risk factors.

5. When to use CPT code 93229

It is appropriate to bill the 93229 CPT code when a patient requires continuous monitoring of their heart’s electrical activity for an extended period, typically up to 30 days, and the data collected is transmitted to a remote attended surveillance center for analysis and reporting. This code should be used for the technical component of the service only, and should not be appended with modifier 26 (Professional component) or TC (Technical component).

6. Documentation requirements

To support a claim for CPT 93229, the following information should be documented:

• Patient’s medical history, including any previous cardiac events or symptoms suggestive of arrhythmias.
• Reason for the continuous monitoring, as determined by the prescribing physician or other qualified health care professional.
• Start and end dates of the monitoring period.
• Details of the wearable electrocardiographic monitoring device used, including the manufacturer and model.
• Instructions provided to the patient on how to use the device and report symptoms or events.
• Daily and emergent data reports prepared by the surveillance center, including any abnormal findings and recommendations for further action.

7. Billing guidelines

When billing for CPT code 93229, keep in mind the following guidelines and rules:

• Report 93229 only once per 30 days.
• Do not report 93229 in conjunction with 93224, 93226.
• For external cardiovascular monitors that do not perform automatic ECG triggered transmissions to an attended surveillance center, see CPT codes 93224-93227, 93268-93272.

8. Historical information

CPT 93229 was added to the Current Procedural Terminology system on January 1, 2009. There have been updates to the code description since its addition, with the most recent change occurring on January 1, 2013.

9. Similar codes to CPT 93229

Five similar codes to CPT 93229 and how they differentiate are:

1. CPT 93224: This code is for external ECG monitoring without automatic ECG triggered transmissions to an attended surveillance center.
2. CPT 93226: This code represents the professional component of external ECG monitoring without automatic ECG triggered transmissions to an attended surveillance center.
3. CPT 93268: This code is for wearable external defibrillator monitoring, which includes ECG monitoring but also provides defibrillation capabilities.
4. CPT 93270: This code is for remote real-time interactive video-conferenced critical care services, which may include ECG monitoring but also encompasses a broader range of critical care services.
5. CPT 93272: This code is for remote real-time interactive video-conferenced evaluation and management services, which may include ECG monitoring but also covers a wider scope of evaluation and management services.

10. Examples

Here are 10 detailed examples of CPT code 93229 procedures:

1. A patient with a history of atrial fibrillation requires continuous ECG monitoring for 30 days to assess the effectiveness of a new medication.
2. A patient who recently experienced a myocardial infarction requires 30 days of continuous ECG monitoring to detect any abnormal heart rhythms that may develop during recovery.
3. A patient with a family history of sudden cardiac death requires 30 days of continuous ECG monitoring to screen for any undiagnosed arrhythmias.
4. A patient experiencing unexplained syncope undergoes 30 days of continuous ECG monitoring to determine if an arrhythmia is the cause of the fainting episodes.
5. A patient with a history of ventricular tachycardia requires 30 days of continuous ECG monitoring to assess the need for an implantable cardioverter-defibrillator.
6. A patient with a pacemaker requires 30 days of continuous ECG monitoring to ensure the device is functioning properly and providing appropriate pacing therapy.
7. A patient with a history of supraventricular tachycardia requires 30 days of continuous ECG monitoring to evaluate the effectiveness of a catheter ablation procedure.
8. A patient with a history of heart failure requires 30 days of continuous ECG monitoring to detect any worsening of their condition or development of new arrhythmias.
9. A patient with a history of long QT syndrome requires 30 days of continuous ECG monitoring to assess the risk of life-threatening arrhythmias and guide treatment decisions.
10. A patient with a history of bradycardia requires 30 days of continuous ECG monitoring to determine if a pacemaker is necessary to maintain an adequate heart rate.