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Consider these options when billing telemetry daily monitoring

APCs Weekly Monitor, March 30, 2007

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QUESTION: Can our hospital code and bill telemetry daily monitoring in conjunction with a chest pain patient in observation?

ANSWER: There is no CPT code for cardiac telemetry daily monitoring; however, there is a revenue code for this service (732). Consider revenue code 732 an ancillary revenue code, and use it in conjunction with these services when provided by a separate department with specially-trained staff.

Typically, separate department staff do not perform cardiac telemetry monitoring. Instead, a facility outfits a particular nursing floor with telemetry monitors which staff on the nursing floor observe. Medical staff usually admit patients to that particular nursing floor because telemetry is medically necessary and a physician orders it. This means that the majority of patients on that floor receive telemetry.

The cost of the equipment and staff of this unit is included in the routine nursing cost center. This means that the telemetry is a routine cost--a fact that has been confirmed by administrative decisions of cases made by the Medicare Provider Reimbursement Review Board (PRRB). Since it's a routine cost, you cannot bill this service with an ancillary revenue code, such as 732.

A hospital has two choices when billing routine costs:

1). Include the charge in the room and board rate (or hourly observation rate) for that nursing unit;

2). Separately bill a charge with a recognized routine cost revenue code, such as 230.

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