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Q: How should I charge and bill for CPT code 93230?

Patient Financial Services Weekly Advisor, January 31, 2008

Q: How should I charge and bill for CPT code 93230?

A: The CPT Manual defines code 93230 as follows:

Electrocardiographic monitoring for 24 hours by continuous original electrocardiogram (ECG) waveform recording and storage without superimposition scanning utilizing a device capable of producing a full miniaturized printout; includes recording, microprocessor-based analysis with report, physician review and interpretation.

Additionally, code 93230 has a status indicator of "B" and the outpatient prospective payment system (OPPS) does not recognize it when you submit it on an outpatient hospital Part B bill type (12x, 13x, and 14x). In other words, this service is not payable under APCs because the description indicates that the code is intended for "physician review and interpretation."

Please review CPT codes 93231 or 93232, as these are the facility components of ECG monitoring for 24 hours. Code 93231-electrocardiographic monitoring for 24 hours by continuous original ECG waveform recording and storage without superimposition scanning utilizing a device capable of producing a full miniaturized printout; recording (includes hook-up, recording, and disconnection)

Code 93232-electrocardiographic monitoring for 24 hours by continuous original ECG waveform recording and storage without superimposition scanning utilizing a device capable of producing a full miniaturized printout; microprocessor-based analysis with report

Source: Glenn Krauss, RHIA, CCS, CCS-P, CPUR, an independent consultant in Maryville, TN.

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