Please refer to the Novitas Local Coverage Determination (LCD) L34997, Real-Time, Outpatient Cardiac Telemetry for reasonable and necessary requirements and frequency limitations.
The Current Procedural Terminology (CPT)/Healthcare Common Procedure Coding System (HCPCS) code(s) may be subject to National Correct Coding Initiative (NCCI) edits. This information does not take precedence over NCCI edits. Please refer to NCCI for correct coding guidelines and specific applicable code combinations prior to billing Medicare.
Procedure codes 93228 and 93229 are reported once per 30 day monitoring period. The date of service is reported on the claim as the date the monitoring period is initiated (i.e., the date the patient is first placed on the monitor).
Technical services (93229) that are transferred from one receiving center to another during the same monitoring period must be reported with the modifier -52. Each entity that provided a portion of the technical portion must report 93229 with the -52 modifier and indicate in the claim narrative the percentage of the total service provided.
Claims for outpatient cardiac telemetry (wearable mobile cardiovascular telemetry) with concurrent real-time data analysis and NOT greater than 24 hours of accessible ECG storage, such as the eCardio eVolution monitor, should not be billed under these codes.