CPT 93244 | Description, Guidelines, Reimbursement, Modifiers & Example (2023)

CPT 93244 can be used for service when the physician performs External Electrocardiographic Recording for more than 48 hours up to 7 days by continuous rhythm recording and storage, review, and interpretation. 

Description of CPT 93244

The official description of CPT code 93244 is: “External electrocardiographic recording for more than 48 hours up to 7 days by continuous rhythm recording and storage; review and interpretation.”

An electrocardiogram CPT 93244 provides a record of cardiac function by a waveform. Any abnormal function or event that disrupts the normal functioning of the heart can be diagnosed from the ECG wave with the help of an ECG monitor.

Conventional ECG machines pick up signals concisely and present data recorded within that interval. However, modern ECG recording procedures have evolved so much that continuous monitoring is possible even while the subject moves. 

The external electrocardiographic recording is recommended where continuous recording is required. Such a recording of ECG waves can go beyond 48 hours amidst various physical activities, including sleep.

A Holter monitor is a device that provides continuous ECG waves and can detect even minor deformities that could be missed with conventional recording. 

The CPT 93244 external electrocardiographic recording is most needed in the following cases. 

• Cardiac arrhythmias
• Chest pain (Angina pectoris)
• Palpitations
• History of Myocardial Infarction
• Shortness of breath
• Coronary Artery Disease
• Acute Coronary Thrombosis
• Dressler’s syndrome
• Acute Ischemic heart disease
• Atherosclerotic heart disease
• Aneurysm of the heart and coronary artery
• Cardiomyopathy
• AV block

CPT Codes For External electrocardiographic recordings

CPT 93244 is categorized under category I codes for External electrocardiographic recording (93241-93248). The following category III codes, 0295T, 0296T, 0297T, and 0298T, were deleted, and new codes were added to category I from Jan 1, 2021.

CPT 93241 bills for service when the physician performs external electrocardiographic recording for more than 48 hours up to 7 days by continuous rhythm recording and storage, including recording, scanning analysis with report, review, and interpretation.

CPT 93242 bills for service when the physician performs external electrocardiographic recording for more than 48 hours up to 7 days by continuous rhythm recording and storage. Billing includes recording (includes connection and initial recording). 

CPT 93243 bills for service when the physician performs external electrocardiographic recording for more than 48 hours up to 7 days by continuous rhythm recording and storage, scanning analysis with a report.

CPT 93244 bills for service when the physician performs external electrocardiographic recording for more than 48 hours up to 7 days by continuous rhythm recording and storage, review, and interpretation.

CPT 93245 bills for service when the physician performs external electrocardiographic recording for more than 48 hours up to 7 days by continuous rhythm recording and storage, including recording, scanning analysis with report, review, and interpretation.

CPT 93246 bills for service when the physician performs external electrocardiographic recording for more than 48 hours up to 7 days by continuous rhythm recording and storage recording (includes connection and initial recording).

CPT 93247 bills for service when the physician performs external electrocardiographic recording for more than 48 hours up to 7 days by continuous rhythm recording and storage, scanning analysis with a report.

CPT 93248 bills for service when the physician performs external electrocardiographic recording for more than 48 hours up to 7 days by continuous rhythm recording and storage, physician review, and interpretation.

Billing Guidelines

The patient record must have a detailed past medical history linked to the necessity of external electrocardiographic recording CPT 93244.

The frequency of symptoms that have occurred over the past must be documented. Reasons for advancing to external electrocardiographic recording must be specified, mentioning why previously recorded short-term signals are unsatisfactory. 

Diagnosed illness should be documented and correlated with the inferences obtained from the external electrocardiographic recording. Further treatment plans to proceed must also be specified.

Billing Example

The following is an example of when CPT 93244 was be billed:

A 52-year-old male patient came for consultation complaining of mild chest pain for the past two days. Unfortunately, he misunderstood it as a gastric disturbance and took three over-the-counter medicines.

The patient reports that he does not smoke or drink alcohol. He appears healthy with a normal BMI. The patient has no history of chronic disorders. 

The physician performs initial checks on blood pressure and lung functions. He then requests a 12-lead ECG to obtain a waveform. Finally, as the symptoms have subsided but re-occur occasionally, the physician advises the patient to go for an external electrocardiographic recording.

This recording goes on for 72 hours. The obtained waveform is evaluated. After analysis, the PR interval is found to be greater than 0.2. The patient is diagnosed with an AV block. The physician referred him to a cardiologist for further treatment.

CPT code 93244 was billed in this case.