How To Use CPT Code 93660

CPT 93660 describes the evaluation of cardiovascular function using a tilt table, continuous ECG monitoring, and intermittent blood pressure monitoring. 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 93660?

CPT 93660 can be used to describe the evaluation of cardiovascular function using a tilt table, continuous ECG monitoring, and intermittent blood pressure monitoring. This code is used when the provider assesses the patient’s heart function while the patient is positioned on a tilt table. The provider may administer medication to increase the heartbeat and repeat the testing to determine the cause of reflex mediated syncope.

2. Official Description

The official description of CPT code 93660 is: ‘Evaluation of cardiovascular function with tilt table evaluation, with continuous ECG monitoring and intermittent blood pressure monitoring, with or without pharmacological intervention.’

3. Procedure

1. The provider positions the patient on a tilt table and connects continuous electrocardiogram (ECG), blood pressure, and pulse monitoring devices.
2. The provider assesses the patient’s resting parameters and then tilts the patient to a 60 to 80 degree angle for about 45 minutes.
3. The provider monitors the patient’s response to the tilt table position and may administer intravenous medication if necessary.
4. The provider repeats the testing and assesses the patient’s response to determine the cause of reflex mediated syncope.

4. Qualifying circumstances

Patients eligible to receive CPT 93660 services are those who experience reflex mediated syncope, also known as neurally mediated, vasodepressor, neurocardiogenic, or vasovagal syncope. The provider must use a tilt table, continuous ECG monitoring, and intermittent blood pressure monitoring during the evaluation. Pharmacological intervention may be used if necessary.

5. When to use CPT code 93660

CPT code 93660 should be used when the provider performs an evaluation of cardiovascular function using a tilt table, continuous ECG monitoring, and intermittent blood pressure monitoring. This code is appropriate when assessing patients with reflex mediated syncope to determine the cause of their symptoms.

6. Documentation requirements

To support a claim for CPT 93660, the provider must document the following information:

• Patient’s symptoms and indication for the evaluation
• Use of a tilt table, continuous ECG monitoring, and intermittent blood pressure monitoring
• Date and duration of the evaluation
• Administration of pharmacological intervention, if applicable
• Assessment of the patient’s response to the tilt table position
• Any additional testing or interventions performed
• Signature of the provider performing the evaluation

7. Billing guidelines

When billing for CPT 93660, ensure that the provider performs the evaluation using a tilt table, continuous ECG monitoring, and intermittent blood pressure monitoring. If the provider does not own the tilt table equipment, append modifier 26 to indicate the professional component. The facility that owns the equipment should report the technical component. If the provider owns the tilt table, report the global code without a modifier, which includes both professional and technical components. Do not report a separately payable evaluation and management (E/M) code on the same day unless the documentation supports a separately identifiable service, in which case modifier 25 should be appended.

8. Historical information

CPT 93660 was added to the Current Procedural Terminology system on January 1, 1992. There have been no updates to the code since its addition.

9. Examples

1. A cardiologist performing an evaluation of cardiovascular function using a tilt table, continuous ECG monitoring, and intermittent blood pressure monitoring to determine the cause of reflex mediated syncope in a patient.
2. An electrophysiologist assessing a patient’s heart function while positioned on a tilt table and administering medication to increase the heartbeat during the evaluation.
3. A cardiac nurse monitoring a patient’s continuous ECG and blood pressure while the patient is tilted on a tilt table to evaluate their cardiovascular function.
4. A cardiovascular technician assisting the provider in performing an evaluation of cardiovascular function using a tilt table, continuous ECG monitoring, and intermittent blood pressure monitoring.
5. A physician administering pharmacological intervention during the evaluation of cardiovascular function using a tilt table, continuous ECG monitoring, and intermittent blood pressure monitoring to assess the patient’s response.
6. A nurse practitioner performing an evaluation of cardiovascular function using a tilt table, continuous ECG monitoring, and intermittent blood pressure monitoring to determine the cause of reflex mediated syncope in a patient.
7. A cardiac technician connecting the patient to continuous ECG, blood pressure, and pulse monitoring devices during the evaluation of cardiovascular function using a tilt table.
8. A physician assistant monitoring the patient’s response to the tilt table position and documenting the findings during the evaluation of cardiovascular function.
9. A cardiovascular technologist assisting the provider in positioning the patient on a tilt table and connecting the monitoring devices for the evaluation of cardiovascular function.
10. A nurse documenting the patient’s symptoms and the provider’s assessment during the evaluation of cardiovascular function using a tilt table, continuous ECG monitoring, and intermittent blood pressure monitoring.