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EKG read with Ambulatory EEG

Wendy Posted Thu 09th of June, 2011 18:35:00 PM

If a video ambulatory EEG is done over a period of 30 days and the patient is hooked up to 1 EKG lead, a sales rep for the EEG equiptment is telling a physician that he can also bill 93272 for the EKG read.

I don't really think that this is correct billing but I cannot find any information at all.

Does anyone have any experience with these that could help?

SuperCoder Answered Thu 09th of June, 2011 19:48:11 PM

The description of the code 93272 written below is self-explanatory.
...
93272 : External patient and, when performed, auto activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attended monitoring; physician review and interpretation
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Analysis:The purpose is to study the patient's heart rhythm during symptoms. The physician instructs the patient in the use of an external rhythm monitor. A technician places ECG leads on the patient's chest, and the monitor uses a symptom-related memory loop mechanism with remote download capability up to 30 days to record the patient's rhythm. During symptoms, the patient activates the monitor by pressing a button. The resulting recording includes ECG activity prior to and during symptoms. The patient uses the device to transmit the recording over the telephone line, allowing a rhythm printout to be generated. The physician reviews and interprets this rhythm strip. For reporting only the physician review and interpretation, code 93272 is used.

Wendy Posted Fri 10th of June, 2011 14:44:13 PM

I understand the description of CPT 93272. My question is - is it medically necessary to bill for along with 95953 since the main purpose of the monitoring is for seizure focus not arrythmias.

SuperCoder Answered Fri 10th of June, 2011 21:04:55 PM

If the main purpose of the monitoring is for seizure, then definitely EEG is the Medical Necessity. To rule out underlying cardiac secondary cause, EKG may be a medical necessity for which it is performed here.
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Therefore, we need to Code both 95953 and 93272.

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