How To Use CPT Code 93264

CPT 93264 describes the remote monitoring of a wireless pulmonary artery pressure sensor for up to 30 days, including weekly downloads of pulmonary artery pressure recordings, interpretation, trend analysis, and report preparation by a physician or other qualified healthcare professional. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 93264?

CPT 93264 can be used to describe the remote monitoring of a wireless pulmonary artery pressure sensor for a period of up to 30 days. This code includes the weekly downloads of pulmonary artery pressure recordings, interpretation of the results, trend analysis, and preparation of a report by a physician or other qualified healthcare professional.

2. Official Description

The official description of CPT code 93264 is: ‘Remote monitoring of a wireless pulmonary artery pressure sensor for up to 30 days, including at least weekly downloads of pulmonary artery pressure recordings, interpretation(s), trend analysis, and report(s) by a physician or other qualified health care professional.’

3. Procedure

1. The physician or qualified healthcare professional reviews the weekly downloads of pulmonary artery pressure recordings from the wireless sensor.
2. They interpret the results of the recordings and analyze any trends that may be present.
3. A report is prepared based on the interpretation and analysis of the recordings.
4. This procedure is performed for a period of up to 30 days, with weekly downloads, interpretation, trend analysis, and report preparation.

4. Qualifying circumstances

CPT 93264 is used for patients who have a wireless pulmonary artery pressure sensor implanted or inserted. This monitoring is typically done for patients with congestive heart failure (CHF) to assess their heart’s pumping capacity, heart rate, systolic and diastolic blood pressures, and other heart functions. The review and analysis of the recordings must occur at least weekly or more often during the 30-day monitoring period.

5. When to use CPT code 93264

CPT code 93264 should be used when a physician or qualified healthcare professional performs remote monitoring of a wireless pulmonary artery pressure sensor for up to 30 days. It is important to note that this code should only be reported if the weekly downloads, interpretation, trend analysis, and report preparation occur at least once per week during the 30-day monitoring period.

6. Documentation requirements

To support a claim for CPT 93264, the physician or qualified healthcare professional must document the following information:

• Proof of the wireless pulmonary artery pressure sensor implantation or insertion
• Date of each weekly download of pulmonary artery pressure recordings
• Interpretation of the results and any trends identified
• Preparation of a report based on the interpretation and analysis
• Signature of the physician or qualified healthcare professional performing the remote monitoring

7. Billing guidelines

When billing for CPT 93264, ensure that the physician or qualified healthcare professional performing the remote monitoring reviews the weekly downloads, interprets the results, analyzes trends, and prepares a report. This code should only be reported once per 30-day period, and the review must occur at least weekly or more often. It is important to note that CPT 93264 should not be reported if the monitoring period is less than 30 days or if the required weekly activities do not occur.

8. Historical information

CPT 93264 was added to the Current Procedural Terminology system on January 1, 2019. There have been no updates or changes to the code since its addition.

9. Examples

1. A physician reviewing weekly downloads of pulmonary artery pressure recordings from a wireless sensor for a patient with congestive heart failure.
2. A qualified healthcare professional interpreting the results and analyzing trends of pulmonary artery pressure recordings obtained through remote monitoring for a patient with a wireless sensor.
3. A physician preparing a report based on the interpretation and analysis of weekly downloads of pulmonary artery pressure recordings from a wireless sensor for a patient with heart failure.
4. A qualified healthcare professional reviewing and analyzing weekly downloads of pulmonary artery pressure recordings from a wireless sensor for a patient with congestive heart failure, and preparing a report on the findings.
5. A physician interpreting the results and trends of pulmonary artery pressure recordings obtained through remote monitoring for a patient with a wireless sensor, and documenting the findings in a report.
6. A qualified healthcare professional reviewing weekly downloads of pulmonary artery pressure recordings from a wireless sensor for a patient with congestive heart failure, and analyzing the trends to assess the patient’s heart function.
7. A physician preparing a comprehensive report based on the interpretation and analysis of weekly downloads of pulmonary artery pressure recordings from a wireless sensor for a patient with heart failure.
8. A qualified healthcare professional reviewing and analyzing weekly downloads of pulmonary artery pressure recordings from a wireless sensor for a patient with congestive heart failure, and documenting the findings in a detailed report.
9. A physician interpreting the results and trends of pulmonary artery pressure recordings obtained through remote monitoring for a patient with a wireless sensor, and preparing a comprehensive report on the patient’s heart function.
10. A qualified healthcare professional reviewing weekly downloads of pulmonary artery pressure recordings from a wireless sensor for a patient with congestive heart failure, and analyzing the trends to assess the effectiveness of the patient’s treatment plan.