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The CPT® Code 93268 refers to a specialized procedure involving the external recording of electrocardiographic (ECG) rhythm data, which is particularly useful for monitoring patients who may experience transient cardiac events. This procedure is designed to capture and analyze the heart's electrical activity over a period of up to 30 days, utilizing an external ECG device that the patient wears during their normal daily activities. The device is equipped with electrodes or leads that are affixed to the patient's chest, allowing for continuous monitoring of the heart's rhythm. The patient is trained on how to operate the device, specifically how to activate it when they experience symptoms such as palpitations or dizziness. The monitoring device operates on a loop mechanism, which means it continuously records ECG data and retains a memory of the most recent events. When the patient activates the monitor during a symptomatic episode, the device saves the ECG data from the memory loop, capturing the 60 to 90 seconds prior to the symptom onset, the duration of the symptomatic period, and a brief period following the cessation of symptoms. This capability is crucial for identifying and diagnosing arrhythmias or other transient cardiac events that may not be evident during a standard ECG performed in a clinical setting. After the data is recorded, it is transmitted to a designated receiving station where a qualified healthcare professional, such as a physician, reviews and interprets the ECG data. This process includes generating a printout of the recorded information, which is essential for further analysis and diagnosis. It is important to note that the reporting of this procedure is specific; CPT® Code 93268 is used for the complete service, which includes the transmission, review, and interpretation of the ECG data. Other related codes, such as 93270, 93271, and 93272, are designated for specific components of the service, ensuring accurate billing and documentation for the various aspects of the ECG monitoring process.
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The procedure associated with CPT® Code 93268 is indicated for patients who exhibit symptoms suggestive of cardiac arrhythmias or other transient cardiac events. These symptoms may include, but are not limited to, the following:
The procedure for CPT® Code 93268 involves several key steps to ensure effective monitoring and data collection:
Post-procedure care for patients undergoing the monitoring associated with CPT® Code 93268 typically involves follow-up consultations to discuss the findings from the ECG data. Patients may be advised on any necessary lifestyle modifications or further diagnostic testing based on the results. Additionally, the healthcare provider may schedule a follow-up appointment to review the interpretation of the ECG data and to discuss potential treatment options if any arrhythmias or other cardiac issues are identified. It is important for patients to report any new or worsening symptoms during the post-procedure period, as this information may influence further management and care.
| Short Descr | ECG RECORD/REVIEW | Medium Descr | XTRNL PT ACTIV ECG TRANSMIS W/R&I 30 DAYS | Long Descr | 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; includes transmission, review and interpretation by a physician or other qualified health care professional | 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) | T2C - Other tests - EKG monitoring | MUE | 1 | CCS Clinical Classification | 203 - Electrographic cardiac monitoring |
| 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. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | 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) | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | GA | Waiver of liability statement issued as required by payer policy, individual case | GC | This service has been performed in part by a resident under the direction of a teaching physician | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | GZ | Item or service expected to be denied as not reasonable and necessary | KX | Requirements specified in the medical policy have been met | SA | Nurse practitioner rendering service in collaboration with a physician | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | 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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| 2013-01-01 | Changed | Description Changed |
| 2011-01-01 | Changed | Long description revised. Medium description changed. Location in hierarchy changed. |
| 2009-01-01 | Changed | Code description changed |
| 2003-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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