Basics of CPT code 93248 , 93245, 93246, 93247
Long-term external electrocardiographic (ECG) recording is a diagnostic procedure that provides continuous rhythm recording of the patient’s heart while the patient is engaged in the activities of daily living. The purpose of the study is to evaluate the patient’s ambient heart rhythm during a full daily cycle. Rhythm disturbances and waveform abnormalities are detected; information is provided regarding the frequency of these disturbances. The physician or other qualified health care provider instructs the patient in the use of the external ECG recorder. A technician places ECG leads on the patient’s chest, and the patient wears the recorder for more than seven days up to 15 days. During this time there is continuous rhythm recording and storage. The patient returns the device and the recorded heart rhythm is converted into digital format by a technician. The technician uses a scanning methodology to classify different ECG waveforms and to generate a report. The generated report describes the overall rhythm and significant arrhythmias.
CPT Code 93245 is reported for the recording, scanning analysis with report, provider review of the data, and the provision of a final interpretation in a report.
CPT Code 93246 is reported for the recording only, which includes the connection and initial recording of data.
CPT Code 93247 is reported only the scanning analysis with report.
CPT Code 93248 is reported for only the provider review and interpretation.
Coding Example CPT code 93245, 93246, 93247, 93248
Example 1 ; A 68-year-old female presents with a prior transient neurologic ischemic episode. Decision is made to proceed with a long-term (greater than 7 days up to 15 days) external electrocardiographic recording to evaluate for possible paroxysmal atrial fibrillation. CPT Code 93245 is used to report ECG recording for more than 7 days and up to 15 days by continuous rhythm recording and storage. This is the complete procedure that includes the ECG recording, scanning analysis with report, and review and interpretation of the results.
Example 2 ; A 68-year-old female presents with a prior transient neurologic ischemic episode. Decision is made to proceed with a long-term (greater than 7 days up to 15 days) external ECG recording to evaluate for possible paroxysmal atrial fibrillation. CPT Code 93246 represents the ECG initial connection and recording. CPT code 93246-93248 describe portions of the complete procedure represented by code 93245.
CPT Code 93246 represents the ECG initial connection and recording, while CPTcode 93247 describes the scanning analysis and report only, and CPT code 93248 describes the review and interpretation of the recording only.
Review the reports created by the technician and create a final summary report. The physician reviews each of the 14 24-hour summaries including (1) heart rate trends (minimum, maximum, average) during waking and sleep hours; (2) tabular summary of supraventricular and ventricular ectopy; (3) any arrhythmias flagged by the technician; (4) any pauses and/or bradyarrhythmias; and (5) event symptoms by the patient in the diary and the correlative ECG recordings to determine if an arrhythmia was present at the time of symptoms.
