Heart Failure Monitoring

Q. How often should a heart failure device be checked?
A. Based on Heart Rhythm Society and manufacturer guidelines, all heart failure devices (also referred to as subcutaneous cardiac rhythm monitor (ICM)) must be monitored continuously and a review of all transmissions must be done at least one time per 30 day period (12 times per year.) Each device manufacturer may have a different recommended monitoring scheduled based on the type of device and its capabilities. Please check with your device manufacturer for further guidance on heart failure transmission scheduling.

Q. What is the technical CPT code for heart failure monitoring?
A. The CPT codes for remote heart failure devices (subcutaneous cardiac rhythm monitor systems/ICM) have been updated to 93297-TC (technical monitoring, EquiMed bills this code) and 93297-26 (Professional Interpretation, Client Provider bills this code). This is now a national Medicare approved set of billing codes. For additional billing information, please contact your device vendor reimbursement department.

Q. How often can you bill 93297?
A.  The professional interpretation CPT code for the remote monitoring of a heart failure device (also referred to as subcutaneous cardiac rhythm monitor system/thoracic impedance monitoring or similar) should be billed once for each 30 day period (on day 31). The professional code (93297-TC) should be billed in conjunction with the appropriate remote monitoring technical code (93297-26). For EquiMed clients, EquiMed bills the technical code while the client provider/practice bills the professional code. Please check with your device manufacturer for specific device capabilities and the recommended remote review schedule.

Q. What is the professional CPT code for heart failure monitoring?
A. For each 30 day monitoring period, CPT 93297-26 should be billed once on day 31 for the review and interpretation of all transmitted patient device data by a physician or other qualified healthcare professional.