Electrocardiographic Monitoring Services Billing - JF Part B
Electrocardiographic Monitoring Services Billing
Overlapping electrocardiographic monitoring denial questions are among the top inquiries received in the Provider Contact Center (PCC).
Providers should contact the referring/ordering provider to determine what service was ordered to ensure proper billing. Electrocardiographic monitoring codes must be billed in sets and sets cannot be completed within 29 days of each other. These codes, per the Current Procedural Terminology (CPT) coding book, are provided in the table below.
| Service | Technical CPT | Professional CPT | Hook up CPT | Global CPT |
|---|---|---|---|---|
| Ambulatory Cardiac Telemetry (ACT) | 93229 | 93228 | Included in 93229 | NA |
| Cardiac Event Monitoring (CEM) | 93271 | 93272 | 93270 | 93268 |
| Holter | 93226 | 93227 | 93225 | 93224 |
The claims processing system reviews all Part A and B claims nationwide for billing overlaps. There are no appeal rights for these denials. If a provider needs assistance in identifying which code caused the denial and the overlapping provider/group, contact the Part B PCC.
See the CMS National Coverage Determination (NCD) for Electrocardiographic Services (20.15) for coverage guidelines to determine medical necessity.
