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External electrocardiographic recording for more than 7 days up to 15 days, as described by CPT® Code 93245, involves the use of a continuous rhythm recording device that captures the heart's electrical activity over an extended period. This procedure allows for long-term monitoring of a patient's cardiac rhythm while they engage in their normal daily activities. The recording device is designed to be compact, lightweight, and waterproof, enabling patients to wear it comfortably without disrupting their routine. The device is typically placed on the upper left chest, where it adheres securely to the skin. Once positioned, the device is tested to ensure proper functionality, and an initial recording is obtained to confirm that it is capturing the necessary data. Patients receive instructions on how to care for and operate the device, which is then activated to continuously record the electrocardiographic (ECG) rhythm for a duration exceeding 7 days but not exceeding 15 days. After the monitoring period, patients return the device to the healthcare facility, where the recorded data is downloaded for further analysis. A computerized analysis is conducted, and a comprehensive report is generated. This report includes a review of the ECG data and a detailed interpretation of the findings by a physician or other qualified healthcare professional. The complete procedure, encompassing rhythm recording, data storage, scanning analysis, and professional interpretation, is reported using CPT® Code 93245. For specific components of the procedure, other codes such as 93246, 93247, and 93248 are utilized to denote recording only, scanning analysis and report only, and physician review and interpretation only, respectively.
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Cardiac Arrhythmias The procedure is indicated for patients who exhibit symptoms of cardiac arrhythmias, such as palpitations, dizziness, or syncope, allowing for the identification and analysis of irregular heart rhythms.
Monitoring of Known Cardiac Conditions It is also indicated for patients with known cardiac conditions who require ongoing monitoring to assess the effectiveness of treatment or to detect any changes in their condition.
Evaluation of Symptoms The procedure may be performed to evaluate unexplained symptoms that may be related to cardiac issues, providing valuable data for diagnosis and management.
Step 1: Device Preparation The procedure begins with the preparation of the external electrocardiographic recording device. The healthcare professional ensures that the device is functioning correctly and that all necessary components, including electrodes and the recording unit, are ready for use.
Step 2: Device Placement The device is then placed on the upper aspect of the patient's left chest. Proper placement is crucial for accurate data collection, and the healthcare provider may clean the skin to enhance electrode adhesion and signal quality.
Step 3: Initial Testing and Recording After placement, the device undergoes an initial testing phase to confirm that it is capturing the ECG signals appropriately. An initial recording is obtained to ensure that the device is functioning as intended.
Step 4: Patient Instruction The patient is instructed on how to use and care for the recording device. This includes guidance on how to maintain the device during daily activities and what to do in case of any issues.
Step 5: Continuous Recording Once the patient is familiar with the device, it is activated to begin continuous ECG rhythm recording. This recording occurs over a period exceeding 7 days but not exceeding 15 days, capturing the heart's electrical activity throughout the patient's normal daily activities.
Step 6: Device Return and Data Download At the end of the monitoring period, the patient returns the device to the healthcare facility. The recorded data is then downloaded from the device for further analysis.
Step 7: Data Analysis and Reporting A computerized analysis of the ECG data is performed, generating a report that includes a detailed review of the findings. A physician or other qualified healthcare professional then interprets the data, providing a written report of the results.
After the procedure, patients may be advised to follow up with their healthcare provider to discuss the results of the ECG analysis. The physician will review the findings and may recommend further testing or adjustments to treatment based on the interpretation of the data. Patients should be informed about any potential symptoms to monitor and when to seek medical attention. Additionally, the healthcare provider may provide guidance on lifestyle modifications or other interventions based on the results of the continuous ECG monitoring.
| Short Descr | EXT ECG>7D<15D REC SCAN A/R | Medium Descr | EXTERNAL ECG REC>7D<15D SCAN ALYS REPORT R&I | Long Descr | External electrocardiographic recording for more than 7 days up to 15 days by continuous rhythm recording and storage; includes recording, scanning analysis with report, review and interpretation | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 4 - Global Test 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 | Items and Services Not Billable to the MAC | Type of Service (TOS) | 5 - Diagnostic Laboratory | Berenson-Eggers TOS (BETOS) | none | MUE | 1 |
| 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. | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 95 | Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system. | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician | GW | Service not related to the hospice patient's terminal condition | GZ | Item or service expected to be denied as not reasonable and necessary | PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2021-01-01 | Added | Code added. |
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