CPT 2011 Changes & Cardiovascular Monitoring Codes

Even though CPT 2011 may not swap your old cardiovascular monitoring codes for new ones, you shouldn't ignore the revisions to this section. One of the goals of changing the codes and accompanying guidelines was to reflect new technology, making accurate reporting of the services easier.



Here are some news on the changes to Holter, mobile cardiovascular telemetry (MCT), and event monitor codes:



Holter monitor time change



This year, holter monitor codes merit a single unit for up to 48 hours. Last year, the code specified for 24 hours. Take a look at this comparison of the old and new codes:

Last year (2010): 93224-93227 -- Wearable electrocardiographic rhythm derived monitoring for 24 hours by continuous original waveform recording and storage, with visual superimposition scanning

This year (2011): 93224-93227 -- External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage



Coder tip: CPT guidelines ask you to append modifier 52 (reduced services) for less than 12 hours of continuous recording.



Take note of just-in 'do not report' rules for MCT



The MCT codes simply alter the first word of the definition from 'wearable' to 'external':

2010: 93228-93229 -- Wearable mobile cardiovascular telemetry

2011: 93228-93229 -- External mobile cardiovascular telemetry



However, that minor change is not all that is new for these codes. Notes with 93228 now clearly teach you not to use the code with holter monitor codes 93224 or 93227. And notes with 93229 tell you not to report it with 93224 or 93226.



CCI edits: CCI 17.0 with effect from January 1, 2011 for physicians, goes an extra mile to make sure you are not reporting MCT and holter monitor codes together.



Earlier, CCI edits permitted you to use a modifier to separate the edits bundling MCT device codes 93228-93229 with Holter monitor codes 93224-93227. The latest version puts a stop to that, adding a '0' indicator to these code pairs.



The edits also change the indicator to 0 for edits bundling MCT codes with event monitor codes 93268-93272. The 0 indicator means you may not use a modifier to override the edit.



Add 'auto activated' in event recorder codes



Just as Holter and MCT codes, the event recorder codes swap wearable for external, thus bringing steady vocabulary to the monitoring services codes. More importantly, this year's codes add that 93268-93272 are proper for auto activated recording when carried out:



Last year: 93268-93272 – Wearable patient activated electrocardiographic rhythm derived event recording with pre symptom memory loop, 24-hour attended monitoring, per 30 day period of time

This year: 93268-93272 – external patient and, when carried out, auto activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attended monitoring



Remember: CPT 2011 axes codes 93012 and 93014 (Telephonic transmission of post-symptom electrocardiogram rhythm strip[s]). This year, you should report those services using event recorder codes 93268- 93272.



For more specialty specific articles to assist your cardiology coding, stay tuned to a good Medical coding resource like Coding Institute.