CPT Codes

The CPT code set describes medical, surgical, and diagnostic services. The following information includes the commonly billed physician codes for cardiac monitoring services/procedures. Consult patient payors to learn more about local requirements and conditions for submission and payment.

Holter Monitoring (<48 hrs)

Code Description
93224 (Global) 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
93225 Recording (includes hook-up, recording, and disconnection)
93226 Scanning analysis with report
93227 Physician review and interpretation

NOTIFICATIONS PARAMETERS PEDIATRIC

NOTIFICATIONS PARAMETERS ADULT

Extended Cardiac Monitoring (>48 hrs)*

Code Description
0295T (Global) External electrocardiographic recording for more than 48 hours up to 21 days by continuous rhythm recording and storage; includes recording, scanning analysis with report, review and interpretation
0296T Recording (includes connection)
0297T Scanning analysis with report
0298T Physician review and interpretation

Documentation Requirements

Documentation supporting medical necessity is vital for ensuring proper reimbursement. Include the following recommended documentation components to support the claim:

  • Patient’s relevant signs and symptoms and pertinent medical history
  • Frequency of symptom occurrence, intermittent symptoms that occur less frequently than every 48 hours may be an indication for long term monitoring
  • Prior test results (particularly previous inconclusive cardiac monitoring tests)
  • Expectations on improved diagnostic implication using long term monitoring
  • The expected level of patient compliance with long-term ECG monitoring

Disclaimer: This information is provided only as a guide and is not intended to replace any official recommendations or guidelines, and does not constitute advice or a promise or guarantee by Warriors Medical regarding coverage or payment. Always check with the patient’s insurance plan for the appropriate use of any CPT procedure or ICD-10-CM diagnosis.

Reimbursement Guide

ICD-10-CM Diagnosis Codes

Extended Holter Monitors are indicated for use in detecting arrhythmia in a wide range of diagnosis, it is important to document the indicators for Long Term Cardiac Monitoring (greater than 48 hours) rather than a regular 24-48-hour Holter, common reasons include a non-diagnostic Holter and infrequent symptoms unlikely to be detected on a 24-48-hour scan.

The following is a list of commonly use ICS-10-CM codes that may assist you in documenting Medical necessity. This is not an exhaustive list of all available codes, and it is possible that there are more appropriate codes for any given diagnosis or symptom. Include all appropriate ICD-10 diagnosis codes and supporting clinical documentation when submitting claims.

Please Note: it is important that you check the Local Coverage Determination from your local Medicare Administrative Contractor as well as your Payors for covered ICD-10 codes as well as other specific requirements and policy updates.

CD-10-CM ICD-10-CM Diagnosis Code/Range
I45.9 Conduction disorder, unspecified
I47.1 Supraventricular tachycardia
I47.2 Ventricular tachycardia
I47.9 Paroxysmal tachycardia
I48.0 Paroxysmal atrial fibrillation
I48.11 Longstanding persistent atrial fibrillation
I48.19 Other, persistent atrial fibrillation
I48.20 Chronic atrial fibrillation, unspecified
I48.21 Permanent atrial fibrillation
I48.3 Typical atrial flutter
I48.4 Atypical atrial flutter
I48.91 Unspecified atrial fibrillation
I48.92 Unspecified atrial flutter
I49.1 Atrial premature depolarization
I49.01 Ventricular fibrillation
I49.02 Ventricular flutter
I49.3 Ventricular premature depolarization
I49.40 Unspecified premature depolarization
I49.49 Other premature depolarization
I49.5 Sick sinus syndrome
I49.8 Other specified cardiac arrhythmias
I49.9 Cardiac arrhythmia, unspecified
I63.9 Cerebral infarction, unspecified
R00.1 Bradycardia, unspecified
R00.2 Palpitations
R42 Dizziness and giddiness [light-headedness]
R55 Syncope and collapse
R56.01 Complex febrile convulsions
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