How To Use CPT Code 93242

CPT 93242 refers to the external electrocardiographic recording for more than 48 hours up to 7 days by continuous rhythm recording and storage, including connection and initial recording. 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 93242 procedures.

1. What is CPT 93242?

CPT 93242 is a medical billing code used to describe the procedure of external electrocardiographic recording for more than 48 hours up to 7 days by continuous rhythm recording and storage. This code is specific to the recording service, including connecting the device and performing the initial recording. It is used by medical coders and billers to accurately document and bill for this particular service.

2. 93242 CPT code description

The official description of CPT code 93242 is: “External electrocardiographic recording for more than 48 hours up to 7 days by continuous rhythm recording and storage; recording (includes connection and initial recording)”.

3. Procedure

The 93242 CPT code procedure involves the following steps:

1. The provider or staff instructs the patient on the use of an external ECG recorder.
2. The monitor is attached to the patient, either as a small patch or with ECG electrodes placed on the patient’s chest connected to a lightweight recorder.
3. The device records the heart’s electrical activity by continuous rhythm recording and storage while the patient goes about their normal activities.
4. The recording occurs for more than 48 hours, up to seven days.
5. After the recording period, the device is removed, and the data is analyzed by the provider.

4. Qualifying circumstances

Patients eligible to receive CPT code 93242 services are those who require continuous monitoring of their heart’s electrical activity for more than 48 hours up to 7 days. This may include patients with symptoms suggestive of cardiac arrhythmias, unexplained syncope, palpitations, or those undergoing evaluation for the effectiveness of antiarrhythmic medications or devices. The provider must determine that this level of monitoring is medically necessary for the patient’s condition.

5. When to use CPT code 93242

It is appropriate to bill the 93242 CPT code when the provider has determined that a patient requires continuous external electrocardiographic recording for more than 48 hours up to 7 days to diagnose or monitor a cardiac condition. This code should be used only for the recording service, including connecting the device and performing the initial recording. It should not be used for the interpretation or analysis of the recorded data.

6. Documentation requirements

To support a claim for CPT 93242, the following information should be documented in the patient’s medical record:

• Medical necessity for the continuous external electrocardiographic recording, including the patient’s symptoms or condition requiring monitoring.
• Duration of the recording (more than 48 hours up to 7 days).
• Details of the device used, including the type of monitor and method of attachment.
• Instructions provided to the patient on the use of the device.
• Date and time of device connection and initial recording.

7. Billing guidelines

When billing for CPT code 93242, it is essential to ensure that the documentation supports the medical necessity of the service and that the procedure has been performed as described. Additionally, be aware of any payer-specific guidelines or requirements related to billing for this code. It is also important to note that CPT 93242 is specific to the recording service and should not be used for the interpretation or analysis of the recorded data.

8. Historical information

CPT 93242 was added to the Current Procedural Terminology system on January 1, 2021. There have been no updates to the code since its addition.

9. Similar codes to CPT 93242

Five similar codes to CPT 93242 and how they differentiate are:

• CPT 93224: This code is for external electrocardiographic recording up to 48 hours by continuous rhythm recording and storage, including recording, scanning analysis, and interpretation.
• CPT 93225: This code is for the recording component of external electrocardiographic recording up to 48 hours by continuous rhythm recording and storage.
• CPT 93226: This code is for the scanning analysis and interpretation component of external electrocardiographic recording up to 48 hours by continuous rhythm recording and storage.
• CPT 93243: This code is for the scanning analysis and interpretation component of external electrocardiographic recording for more than 48 hours up to 7 days by continuous rhythm recording and storage.
• CPT 93245: This code is for external electrocardiographic recording for more than 7 days up to 15 days by continuous rhythm recording and storage, including recording, scanning analysis, and interpretation.

10. Examples

Here are 10 detailed examples of CPT code 93242 procedures:

1. A patient with a history of palpitations and episodes of dizziness undergoes continuous external electrocardiographic recording for 5 days using a patch monitor to evaluate for possible arrhythmias.
2. A patient with a recent diagnosis of atrial fibrillation is monitored for 6 days using a continuous external ECG recorder to assess the effectiveness of a newly initiated antiarrhythmic medication.
3. A patient with unexplained syncope undergoes 7 days of continuous external electrocardiographic recording using a chest electrode-based monitor to evaluate for potential cardiac causes.
4. A patient with a history of ventricular tachycardia is monitored for 4 days using a continuous external ECG recorder to assess the effectiveness of an implanted cardioverter-defibrillator.
5. A patient with a recent myocardial infarction undergoes 5 days of continuous external electrocardiographic recording using a patch monitor to evaluate for potential arrhythmias during recovery.
6. A patient with a family history of sudden cardiac death undergoes 6 days of continuous external ECG recording to evaluate for potential inherited arrhythmias.
7. A patient with a history of recurrent atrial flutter is monitored for 7 days using a continuous external ECG recorder to assess the effectiveness of a catheter ablation procedure.
8. A patient with a history of bradycardia and fatigue undergoes 4 days of continuous external electrocardiographic recording using a chest electrode-based monitor to evaluate for potential pacemaker placement.
9. A patient with a recent diagnosis of long QT syndrome is monitored for 5 days using a continuous external ECG recorder to assess the effectiveness of a newly initiated beta-blocker medication.
10. A patient with a history of supraventricular tachycardia undergoes 6 days of continuous external electrocardiographic recording using a patch monitor to evaluate for potential triggers and frequency of episodes.