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The CPT® Code 93243 refers to the procedure of external electrocardiographic recording that is conducted for a duration exceeding 48 hours and up to 7 days. This procedure involves continuous rhythm recording and storage, followed by a scanning analysis that culminates in a comprehensive report. In simpler terms, this long-term electrocardiographic (ECG) monitoring allows for the assessment of a patient's heart rhythm over an extended period while they engage in their normal daily activities. The technology used in this procedure typically consists of a compact, lightweight, and waterproof device that integrates both the electrodes and the recording apparatus, enabling patients to wear it comfortably for up to 21 days. During the procedure, the device is affixed to the upper left chest of the patient, and an initial test recording is performed to ensure proper functionality. Patients receive instructions on how to use and care for the device effectively. Once activated, the device continuously records and stores the ECG rhythm for the specified duration. After the monitoring period concludes, the patient returns the device to the healthcare facility, where the recorded data is downloaded. A computerized analysis is then conducted, and a detailed report is generated. This report is subsequently reviewed by a physician or another qualified healthcare professional, who provides a written interpretation of the findings. The coding for this procedure is specific, with different codes assigned for various components of the ECG monitoring process, ensuring accurate billing and documentation of the services rendered.
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The procedure associated with CPT® Code 93243 is indicated for patients who require extended monitoring of their cardiac rhythm to identify potential arrhythmias or other heart-related issues that may not be detected during a standard ECG. This long-term monitoring is particularly useful for patients experiencing symptoms such as:
The procedure for CPT® Code 93243 involves several key steps to ensure accurate and effective monitoring of the patient's cardiac rhythm:
After the completion of the procedure associated with CPT® Code 93243, the patient may be advised on several post-procedure considerations. Typically, there are no specific restrictions following the return of the device, as the patient has already engaged in their normal daily activities during the monitoring period. However, the physician may recommend follow-up appointments to discuss the findings of the ECG report. Depending on the results, further diagnostic testing or treatment options may be considered. It is also important for the patient to report any ongoing symptoms or new developments to their healthcare provider, as these may influence the management of their cardiac health.
| Short Descr | EXT ECG>48HR<7D SCAN A/R | Medium Descr | EXTERNAL ECG REC>48HR<7D SCANNING ALYS W/REPORT | Long Descr | External electrocardiographic recording for more than 48 hours up to 7 days by continuous rhythm recording and storage; scanning analysis with report | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 3 - Technical Component Only Code | Multiple Procedures (51) | 6 - Special payment adjustment rules on the technical component (TC) of multiple diagnostic cardiovascular services apply... | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 01 - Procedure must be performed under the general supervision of a physician. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | STV-Packaged Codes | Type of Service (TOS) | 5 - Diagnostic Laboratory | Berenson-Eggers TOS (BETOS) | none | MUE | 1 |
| XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | GW | Service not related to the hospice patient's terminal condition | 25 | Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service: it may be necessary to indicate that on the day a procedure or service identified by a cpt code was performed, the patient's condition required a significant, separately identifiable e/m service above and beyond the other service provided or beyond the usual preoperative and postoperative care associated with the procedure that was performed. a significant, separately identifiable e/m service is defined or substantiated by documentation that satisfies the relevant criteria for the respective e/m service to be reported (see evaluation and management services guidelines for instructions on determining level of e/m service). the e/m service may be prompted by the symptom or condition for which the procedure and/or service was provided. as such, different diagnoses are not required for reporting of the e/m services on the same date. this circumstance may be reported by adding modifier 25 to the appropriate level of e/m service. note: this modifier is not used to report an e/m service that resulted in a decision to perform surgery. see modifier 57 for significant, separately identifiable non-e/m services, see modifier 59. | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | GF | Non-physician (e.g. nurse practitioner (np), certified registered nurse anesthetist (crna), certified registered nurse (crn), clinical nurse specialist (cns), physician assistant (pa)) services in a critical access hospital | GZ | Item or service expected to be denied as not reasonable and necessary | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter |
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| 2021-01-01 | Added | Code added. |
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