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Understand ECG Codes

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We have previously billed code 93224 for a 24-hour ECG study that included hook-up, recording, physician review, and interpretation. However, I’ve just been told we should be using 93268. Which is right?

Question: We have previously billed code 93224 for a 24-hour ECG study that included hook-up, recording, physician review, and interpretation. However, I’ve just been told we should be using 93268. Which is right?

Answer: You need to take a close look at the 2007 CPT code book and study the descriptions for these codes. You know better than we do what you are actually doing and charting.

Briefly, 93224 is for “electrocardiographic monitoring for 24 hours by continuous original ECG waveform recording and storage, with visual superimposition scanning; includes recording, scanning analysis with report, physician review and interpretation.”

93268 is for “Patient demand single or multiple event recording with presymptom memory loop, 24 hour attended monitoring, per 30 day period of time; includes transmission, physician review and interpretation.”

(In other words, is it continuous [93224] or does the patient press a button when feeling symptoms [93268]?) 93270 is associated with 93268 but is for just recording.

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