2009 Technical Reimbursement Rate

[Anonymous]

It is one of the 3 sets of holters codes. Set 3 is 93235,93236,93237. It also states 24 hrs.

If you look in the AMA book around page 410 or so, it states for code 93237. "For wearable mobile telemetry with ECG triggered events to an attended surveillance center." It also says see 93228, 93229. Which says only to report once per 30 days. This is from the Insiders View book which states all the changes.

 

[Anonymous]

If you look in the AMA book around page 410 or so, it states for code 93237. "For wearable mobile telemetry with ECG triggered events to an attended surveillance center." It also says see 93228, 93229. Which says only to report once per 30 days. This is from the Insiders View book which states all the changes.

It is on page 408, I have it in front of me. 93237 is the physician review and interpretation of code 93235. under that is a note for wearable mobile telemetry with ECG triggered events to an attended surveillance center see 93228, 93229. 93228 and 29 are the codes to be billed once per 30 days.

93235 says Wearable ECG rhythm derived monitoring for 24 hours by continuous computerized monitoring and non-continuous recording, and real-time data analysis utilizing a device capable of producing intermittent full sized waveform tracings, possibly patient activated.

My interpretation of this is that doctors using Cardionet or Lifewatch MCT must bill 93228 only once per 30 days. 93237 can be billed once every 24 hours. If the ecardio device meets this code (I'm not saying it does) then it can be billed this way. The ecardio device is clearly not telemetry. I would like to know, how does the ecardio device meet this code and not the event code? Please give me an intellegent answer, without any insults. Thank you

 

[Anonymous]

It is on page 408, I have it in front of me. 93237 is the physician review and interpretation of code 93235. under that is a note for wearable mobile telemetry with ECG triggered events to an attended surveillance center see 93228, 93229. 93228 and 29 are the codes to be billed once per 30 days.

93235 says Wearable ECG rhythm derived monitoring for 24 hours by continuous computerized monitoring and non-continuous recording, and real-time data analysis utilizing a device capable of producing intermittent full sized waveform tracings, possibly patient activated.

My interpretation of this is that doctors using Cardionet or Lifewatch MCT must bill 93228 only once per 30 days. 93237 can be billed once every 24 hours. If the ecardio device meets this code (I'm not saying it does) then it can be billed this way. The ecardio device is clearly not telemetry. I would like to know, how does the ecardio device meet this code and not the event code? Please give me an intellegent answer, without any insults. Thank you

It does not meet the code as the device it is. Now eCardio says they made an addition which allows it to meet the code. I've asked physicians where they have been promoting this device and the physicians can not tell me what the difference is between this device and MCOT. They also do not tell me what the addition is. All I have been told is that eCardio says they designed this device around the code. They do not even tell the physicians what the addition is.

I think you are somewhat correct on the code. I think this code, which is around 15 years old, is either holter or maybe hospital monitoring of some kind.

I have a contact within CMS that is looking into this. I also have a family member who works for a practice management company, not in cardiology, but they have some contacts and they are looking into this.

If the code and device are legit, then we rely on the clinical value of MCOT. There will always be physicians which weigh the financial opportunities more heavily. I for one am not worried about eCardio getting any of my business. I just want to have the facts straight so I can promote my product vs. theirs fairly. In the end clinical value and service win out.

 

[Anonymous]

Dude you can not just add things to a device and call it whatever you want without a FDA clearnence, dumb #$%! This is Medicine and lives you are #@$%^*# with!
MARK my words, you will not be around in 2 months, Trust me! Does HMS sound familiar to you? Same team you have now ran that company, read the monitoring history books. They are stocking away the money so when things get tight they will close shop and disapear in less then a day. I look forward to talking to you further on this board in 2 months, can not WAIT!

Just keep spewing the crap out of your head. You only need a 510K when and I quote from the FDA "There is a change or modification of a legally marketed device and the change could significantly affect its safety or effectiveness." To add what we added to the Braemar unit does not require a 510K. As I said before, every accusation you make, I come in with facts and you lose credability. I will out sell you any day of the week.
Oh by the way, where can I purchase the monitoring history book. I would like to read about all the crap your company has pulled off in the last few years.

 

[Anonymous]

ecardio believes that just because they transmit daily you can bill daily. They have the unit transmit a strip a day.
What is the difference between having a patient with an auto trigger device transmitting once a day at a predetermined time? Can I now bill my autotrigger daily if the patient transmits daily? The code does not say anything about remotely (or cellular) transmitting.

 

[Anonymous]

ecardio believes that just because they transmit daily you can bill daily. They have the unit transmit a strip a day.
What is the difference between having a patient with an auto trigger device transmitting once a day at a predetermined time? Can I now bill my autotrigger daily if the patient transmits daily? The code does not say anything about remotely (or cellular) transmitting.

As I read the code, having the unit, not the patient transmit daily makes them able to bill daily. The device does do everything the code says so my docs are giving it a try. It was very painful trying to get an answer, but now I think we have all the information. The ecardio unit is easier for the patient. It is better than a phone in monitor. It is worth a try.

 

[Anonymous]

You must be reading the wrong code. None of them say anything about transmitting, only fetching.

 

[Anonymous]

Can you say " Loophole "? Maybe the eVolution is easier for the patient than MCOT and maybe it offers a little more than its first cuz the autotrigger. Does anyone see the problem with telling physicians to bill daily for an interp? Come on, it adds up to more than physicians get for doing some invasive procedures. When you make up crap like, " we designed it around this code." You set yourself up for ultimate failure and talk about the rest of us losing credibility, you will be the first on the list.

You may very well have found a loophole around the coding process, however, do you really think that CMS and the privates will not close this loophole sooner than later. Then what will you base your story on?

I hope you are a great rep. You will need to rely on those tremendous skills when this flies back in your face.

 

[Anonymous]

From the book, "cpt 2009, changes, an insider's view"

pg 170: Codes 93224-93247 were revised to specify wearable electrocardiography rhythm- derived monitoring. A parenthetical note was added following code 93237 referring users to codes 93228 and 93229 for wearable mobile telemetry with " ECG- triggered" transmissions to an attended surveillance center.

If the ER920W utilizes ECG triggered transmissions to an attended surveillance center how can eCardio use code 93237? 93237 would fit the traditional auto trigger event recorders better.

What is the secret ingredient that eCardio added to this device to make it fit 93237? Can anyone answer this question and put an end to the mystery? The ER920W is not MCOT but has ecg triggered transmissions. Maybe eCardio does not have an attended monitoring center and that is the answer?

 

[Anonymous]

From the book, "cpt 2009, changes, an insider's view"

pg 170: Codes 93224-93247 were revised to specify wearable electrocardiography rhythm- derived monitoring. A parenthetical note was added following code 93237 referring users to codes 93228 and 93229 for wearable mobile telemetry with " ECG- triggered" transmissions to an attended surveillance center.

If the ER920W utilizes ECG triggered transmissions to an attended surveillance center how can eCardio use code 93237? 93237 would fit the traditional auto trigger event recorders better.

What is the secret ingredient that eCardio added to this device to make it fit 93237? Can anyone answer this question and put an end to the mystery? The ER920W is not MCOT but has ecg triggered transmissions. Maybe eCardio does not have an attended monitoring center and that is the answer?

After searching for CPT 93237, I followed the links to this posting.
I’ve just read this entire thread and as an outsider claiming ignorance up front, I have to say I have never encountered such professional arrogance. Using the very word professional is inaccurate to describe the childlike barrage of insults. It’s clear to me that one company was billing 93237, perhaps in error, a new code announcement in 01-09 put and end to that company’s qualification to bill that code leaving it with a very small reimbursement. Another company claims to meet this new criteria and it’s impossible for the first company to accept… Why? Things like this happen all of the time… so what!!! We live in a fluid, subject to change, society. Either you evolve to meet these new changes or you can continue to insist the world flat. I have seen both of these devices at shows. One is worn as a medallion and seems a bit cumbersome or potentially uncomfortable. The other, newer device is a single unit basically connected like previous event monitors would be. Patient acceptance, compliance would be determining factors to me not reimbursements. To the first company, I would suggest that you develop a better product and move on. Spend your money on R&D instead of lobbying efforts in Washington. This would allow the technology to advance without possible bureaucratic influence.

 

[Anonymous]

Obviously there is more than 2 companies in this argument. Outsider my ass!!! Everyone knows and acknowledges that one is a superior product (except you). It comes down to billing.
You are a scam artist that is going to get caught.

 

[Anonymous]

Obviously there is more than 2 companies in this argument. Outsider my ass!!! Everyone knows and acknowledges that one is a superior product (except you). It comes down to billing.
You are a scam artist that is going to get caught.

No scams here... But the scam artist has already been caught... Your own words "It comes down to billing" undermine everything you've been crying about. Make no mistake, It is about clinical acceptance; it's about decreasing morbidly and mortality by identifying AF in patients. You better recalibrate your moral compass and concentrate on these points.
Embrace the challenge that’s been handed to you and try to make a difference if you can. If you can’t, then based on the flamboyant intellect demonstrated in your previous responses, you might want to try selling used cars. Either way it means working harder.
I’m surprised you were that easy.
BTW: I am not affiliated with any companies…nor is that obvious as you suggest. It would seem that jumping to the wrong conclusion is something you do quite compulsively.

 

[Anonymous]

No scams here... But the scam artist has already been caught... Your own words "It comes down to billing" undermine everything you've been crying about. Make no mistake, It is about clinical acceptance; it's about decreasing morbidly and mortality by identifying AF in patients. You better recalibrate your moral compass and concentrate on these points.
Embrace the challenge that’s been handed to you and try to make a difference if you can. If you can’t, then based on the flamboyant intellect demonstrated in your previous responses, you might want to try selling used cars. Either way it means working harder.
I’m surprised you were that easy.
BTW: I am not affiliated with any companies…nor is that obvious as you suggest. It would seem that jumping to the wrong conclusion is something you do quite compulsively.

 

[Anonymous]

After searching for CPT 93237, I followed the links to this posting.
I’ve just read this entire thread and as an outsider claiming ignorance up front, I have to say I have never encountered such professional arrogance. Using the very word professional is inaccurate to describe the childlike barrage of insults. It’s clear to me that one company was billing 93237, perhaps in error, a new code announcement in 01-09 put and end to that company’s qualification to bill that code leaving it with a very small reimbursement. Another company claims to meet this new criteria and it’s impossible for the first company to accept… Why? Things like this happen all of the time… so what!!! We live in a fluid, subject to change, society. Either you evolve to meet these new changes or you can continue to insist the world flat. I have seen both of these devices at shows. One is worn as a medallion and seems a bit cumbersome or potentially uncomfortable. The other, newer device is a single unit basically connected like previous event monitors would be. Patient acceptance, compliance would be determining factors to me not reimbursements. To the first company, I would suggest that you develop a better product and move on. Spend your money on R&D instead of lobbying efforts in Washington. This would allow the technology to advance without possible bureaucratic influence.

Can the event monitoring services bill the same ( 93237 )? Can they get their hands on the secret ingredient that eCardio got?

 

[Anonymous]

Can the event monitoring services bill the same ( 93237 )? Can they get their hands on the secret ingredient that eCardio got?

(93237) is a holter code! What is special about an event monitor that auto triggers using wireless transmission??? How does this fall under the 93237 definition? The sauce?

 

[Anonymous]

After searching for CPT 93237, I followed the links to this posting.
I’ve just read this entire thread and as an outsider claiming ignorance up front, I have to say I have never encountered such professional arrogance. Using the very word professional is inaccurate to describe the childlike barrage of insults. It’s clear to me that one company was billing 93237, perhaps in error, a new code announcement in 01-09 put and end to that company’s qualification to bill that code leaving it with a very small reimbursement. Another company claims to meet this new criteria and it’s impossible for the first company to accept… Why? Things like this happen all of the time… so what!!! We live in a fluid, subject to change, society. Either you evolve to meet these new changes or you can continue to insist the world flat. I have seen both of these devices at shows. One is worn as a medallion and seems a bit cumbersome or potentially uncomfortable. The other, newer device is a single unit basically connected like previous event monitors would be. Patient acceptance, compliance would be determining factors to me not reimbursements. To the first company, I would suggest that you develop a better product and move on. Spend your money on R&D instead of lobbying efforts in Washington. This would allow the technology to advance without possible bureaucratic influence.

I am also an outsider and your original post does not make any sense. How is a "Medallion" more "cumbersome" and "potentially uncomfortable" versus a larger single unit? The medallion is like previous event monitors, not a larger single unit consistently worn on a belt (how do women carry it most of the time?).... No one ever mentioned anything about "lobbying efforts in Washington". Where did you get that from?
How many pages of links did you sift through searching about 93237 before coming across this posting? You're a pretty shitty BS'er.
From,
A real outsider

 

[Anonymous]

No scams here... But the scam artist has already been caught... Your own words "It comes down to billing" undermine everything you've been crying about. Make no mistake, It is about clinical acceptance; it's about decreasing morbidly and mortality by identifying AF in patients. You better recalibrate your moral compass and concentrate on these points.
Embrace the challenge that’s been handed to you and try to make a difference if you can. If you can’t, then based on the flamboyant intellect demonstrated in your previous responses, you might want to try selling used cars. Either way it means working harder.
I’m surprised you were that easy.
BTW: I am not affiliated with any companies…nor is that obvious as you suggest. It would seem that jumping to the wrong conclusion is something you do quite compulsively.

Ask any MD about the importance of billing. Clinical acceptance is heavily weighted on the all mighty dollar.

 

[Anonymous]

I am also an outsider and your original post does not make any sense. How is a "Medallion" more "cumbersome" and "potentially uncomfortable" versus a larger single unit? The medallion is like previous event monitors, not a larger single unit consistently worn on a belt (how do women carry it most of the time?).... No one ever mentioned anything about "lobbying efforts in Washington". Where did you get that from?
How many pages of links did you sift through searching about 93237 before coming across this posting? You're a pretty shitty BS'er.
From,
A real outsider

I'm not an outsider, but I do not work for Cardionet or Ecardio and I love reading this forum. Makes me LOL. Did you forget about the larger recorder that is worn on the hip. Two leads and a single unit is more comfortable and easier than three leads, a medallion and a recorder. There is no proof that it is any better than an auto detect CEM. If there is I have not seen it. I have a lot of business from accounts that do not want to be bothered with MCT. Ecardio is taking away some of the business because of the auto send feature and billing. I want to know why they can bill daily, but no one can give a straight answer. As for the lobbying effort, it is public information available on the internet. It comes up when you run a google search.

 

[Anonymous]

With all the chatter about codes and billing I did some checking. I'm worried, when checking with Highmark on the codes 93228,93229, the professional lists the amount for the interp, however, the code for the tech reads $0. Why is this? Then I heard that the reimbursement was going to be set or relative value units would be assigned to the technical in June or July?

I checked on the 93237 code eCardio is telling accounts to bill and an account of mine that started using them for the daily interp fee has been told by the practice manager that they are not to use this code anymore. Maybe it is coming back on them. I told my accounts to ask eCardio what code they bill for the technical and it causes a them to produce a very confusing answer as to why they can bill the MCT code ( to get more reimbursement ) but their accounts don't have to bill the MCT code for the professional. Can't have it both ways eCardio, not anymore.

 

[Anonymous]

With all the chatter about codes and billing I did some checking. I'm worried, when checking with Highmark on the codes 93228,93229, the professional lists the amount for the interp, however, the code for the tech reads $0. Why is this? Then I heard that the reimbursement was going to be set or relative value units would be assigned to the technical in June or July?

I checked on the 93237 code eCardio is telling accounts to bill and an account of mine that started using them for the daily interp fee has been told by the practice manager that they are not to use this code anymore. Maybe it is coming back on them. I told my accounts to ask eCardio what code they bill for the technical and it causes a them to produce a very confusing answer as to why they can bill the MCT code ( to get more reimbursement ) but their accounts don't have to bill the MCT code for the professional. Can't have it both ways eCardio, not anymore.

Been reading this post...
93237 is NOT a holter code... 93237 (CPT) - Electrocardiographic monitoring for 24 hours by continuous computerized monitoring and non-continuous recording, and real-time data analysis utilizing a device capable of producing intermittent full-sized waveform tracings, possibly patient activated; physician review and interpretation. This is exactly to the letter what eCardio provides, there is no secret sauce, there is no having it both ways ( the code sets have to match) Why would the PM know or care about what ecardio bills as long as they bill the matching code. Objectivly, there is always confusion when there is billing change, why would there not be? If the process was smooth, we would not be needed and everything that we do could be done over the phone, for any company. Again, look at the code and look at what ecardio does... Thanks