2009 Technical Reimbursement Rate

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Well today is a happy day! eCardio is now screwed. Trailblazer has now stated that code 93237 is not appropriate. ( I will not post the link but it shouldnt be hard to find) Now CN and LW will get the few accounts they lost over the past 3 months back instantly. Stay away from the big boys kids...
 






Anonymous said:
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
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93224 to 93237 ARE holter codes. Even your quote says "24 hours" no idea why people try to argue that point. Google "holter cpt codes" and one of the first is Aetna showing all the holter codes. Like you said, look at the code, and why can't ANY auto-trigger event monitor fall into it? eCardio also fits the standard event code. Since they are a "digital looping event monitor" per the 510k, they need to bill as such.
The nice thing is now most Medicare's are only going to cover 1-2 days of this per 6 months (just like a holter!!!). Good luck getting 30 days out of the code. Offices are starting to get EOB's showing this. LW and CN only had 2-3 MediCare territories that agreed to reimburse this way. eCardio has offices billing all of them this way, and it sent a red flag.
 






Anonymous said:
93224 to 93237 ARE holter codes. Even your quote says "24 hours" no idea why people try to argue that point. Google "holter cpt codes" and one of the first is Aetna showing all the holter codes. Like you said, look at the code, and why can't ANY auto-trigger event monitor fall into it? eCardio also fits the standard event code. Since they are a "digital looping event monitor" per the 510k, they need to bill as such.
The nice thing is now most Medicare's are only going to cover 1-2 days of this per 6 months (just like a holter!!!). Good luck getting 30 days out of the code. Offices are starting to get EOB's showing this. LW and CN only had 2-3 MediCare territories that agreed to reimburse this way. eCardio has offices billing all of them this way, and it sent a red flag.
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continuous computerized monitoring and non-continuous recording,right? What holter does that? Holters record non-stop. Computerized Monitoring=analysis through some type of wave interrogation or algorithm. Again, holter or CEM? Why was it OK for CN to bill under this code when their device records continuous? The code specifies non-continuous recording and yet CN billed this code. Either way it doen't matter, our business is good and growing. You go out and pedal your 5+ year old technology all you want Big Boy.
 






The codes to which you refer are old, REAL TIME HOLTER codes. Back in the old days, companies tried to market Holters with the analysis performed in the recorder. That is why you have the continuous monitoring selective recording verbiage. They were proven not to work so hot, but many companies were successful marketing them by taking advantage of people's greed and lust for relatively high reimbursement. ECardio, as Yogi Berra would say, is Deja Vue all over again.
 






Anonymous said:
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
Click to expand...

You are wrong. 93237 is a third generation holter code. This is not up for debate. It has been around for some time. The reason a PM would care is that you can no longer bill daily per CMS. Private insurance will follow close behind. I would like to know what Braemar's 510k says this device is, an event monitor or a MCOT? What code does eCardio bill? The 93229 or the 93235? The reason I ask is because an eCardio rep says they bill the 93229, therefore, the codes are not in matching sets.

In this market some find it easier to distinguish themselves by offering financial incentives to get evalutations ( either low fee for services with event monitors, daily billing, etc. ). In the long run it hurts everyone. The market is wide open. Sell yourself, company, clinical efficacy and service. The rest will fall into place.
 












Anonymous said:
continuous computerized monitoring and non-continuous recording,right? What holter does that? Holters record non-stop. Computerized Monitoring=analysis through some type of wave interrogation or algorithm. Again, holter or CEM? Why was it OK for CN to bill under this code when their device records continuous? The code specifies non-continuous recording and yet CN billed this code. Either way it doen't matter, our business is good and growing. You go out and pedal your 5+ year old technology all you want Big Boy.
Click to expand...
Since MCOT was new technology insurance companies dictated what code they would reimburse with, that is why CN had 4 different codes. You losers were not smart enough to know this, that is how you got noticed. CN had approval, you don't.
 






Anonymous said:
You are wrong. 93237 is a third generation holter code. This is not up for debate. It has been around for some time. The reason a PM would care is that you can no longer bill daily per CMS. Private insurance will follow close behind. I would like to know what Braemar's 510k says this device is, an event monitor or a MCOT? What code does eCardio bill? The 93229 or the 93235? The reason I ask is because an eCardio rep says they bill the 93229, therefore, the codes are not in matching sets.

In this market some find it easier to distinguish themselves by offering financial incentives to get evalutations ( either low fee for services with event monitors, daily billing, etc. ). In the long run it hurts everyone. The market is wide open. Sell yourself, company, clinical efficacy and service. The rest will fall into place.
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It is a Braemar ER920W. "digital looping event recorder". eCardio would have to bill 93236 (35 is global). I serious doubt they are trying to bill 229 even though it is more money. They do not have FDA indication/classification.
 












Anonymous said:
WOW!!! I see no point in going on any further with this discussion. You are obviously a small minded individual, who can not accept anything that is different in your world. You have proven your stupidity on numerous posts with comments like this. This code has been around for years, eCardio made the eVolution fit this code and it works. It had nothing to do with "powers that be." Accounts are happy and getting paid. I am sorry you can not accept it.
The facts are that the eVolution is not the same as the Braemar unit, so stop comparing the two. eCardio is growing at a rapid rate by taking away hook ups that belonged to Cardionet. I personally have taken away over 150 hook ups that belonged to Cardionet just last month. The Cardionet rep in part of my area has tried to tell my accounts anything to keep the business, just like you are here. (it may be you for all I know) They see right through it because for every accusation you make, I come in with facts and proof that we meet the code and are different than Braemar. This just makes Cardionet lose creditability, so save face and give up.
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No recent comments? How is it going now smart guy? How do these accounts feel that they have to refund all that money? How are your "facts" working now? Losers!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
 


















Anonymous said:
continuous computerized monitoring and non-continuous recording,right? What holter does that? Holters record non-stop. Computerized Monitoring=analysis through some type of wave interrogation or algorithm. Again, holter or CEM? Why was it OK for CN to bill under this code when their device records continuous? The code specifies non-continuous recording and yet CN billed this code. Either way it doen't matter, our business is good and growing. You go out and pedal your 5+ year old technology all you want Big Boy.
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How good is it now? I am surprised we have not heard from you. Have all you guys quit yet? Are you helping the accounts write the checks returning all that great reimbursed money? LOL!
 






The Ecardio folks must be pretty bummed out now. Cardionet was so affected by Ecardio, they bought the manufacturer. If you can't beat 'em buy 'em!

A small time acquisition of 14MM is in no way going to get Cardionet anywhere near 50% growth this year. Q1 numbers will be out soon and maybe then we will finally get the scoop on the technical reimbursement rate.
 






I hear a TX Medicare provider has thrown the hammer down on billing codes 93235, 93236 and the infamous 93237. Saying, " they are not appropriate for billing for long term monitoring." They are infact, as we have known, holter codes.

eCardio, I guess you forgot to tell them what you added to the monitor to get around this code.

Way to go. We all told you so.
 






Anonymous said:
The Ecardio folks must be pretty bummed out now. Cardionet was so affected by Ecardio, they bought the manufacturer. If you can't beat 'em buy 'em!

A small time acquisition of 14MM is in no way going to get Cardionet anywhere near 50% growth this year. Q1 numbers will be out soon and maybe then we will finally get the scoop on the technical reimbursement rate.
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Again, $1124.
 






Anonymous said:
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!
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LOL Guess it did not take as long as I thought it would LOL C YA Ecardio HAHA
 












HMS was a cardiac Event provider from Boca Raton. Back in the early-mid 90s, the reimbursement for event monitoring was very confusing as some insureres had no real policy. So, many entrepreneurs found loopholes that enabled them to bill and collect large sums. Back in the day, there were many such companies in TX and Phila. and So. FL. As the reimbursements would change geographically, many of these companies would pack up and move from place to place. Anyone remember Medibar? Some things never change.
 






Anonymous said:
HMS was a cardiac Event provider from Boca Raton. Back in the early-mid 90s, the reimbursement for event monitoring was very confusing as some insureres had no real policy. So, many entrepreneurs found loopholes that enabled them to bill and collect large sums. Back in the day, there were many such companies in TX and Phila. and So. FL. As the reimbursements would change geographically, many of these companies would pack up and move from place to place. Anyone remember Medibar? Some things never change.
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Thanks... Medibar??? Are your serious? That sounds like a pub across the street from a hospital
 






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