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Primary Care Coding Alert

Reader Questions:

Use These Time Parameters for Holter Monitor Codes

Question: If a patient on a Holter monitor provides data for 7 days and 8 hours, do I round down to the nearest day and use 93241, or do the extra hours enable me to use 93245?

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Answer: The CPTgeneral instructions for time-based coding, which tell you that 鈥渁 unit of time is attained when the mid-point is passed,鈥 do not apply to 93241 (External electrocardiographic recording for more than 48 hours up to 7 days by continuous rhythm recording and storage 鈥) or 93245 (External electrocardiographic recording for more than 7 days up to 15 days by continuous rhythm recording and storage 鈥). That鈥檚 because the wording in the code descriptors does not indicate a simple range (such as the office/outpatient evaluation and management [E/M] codes) or an 鈥渁pproximate鈥 time (such as the preventive medicine individual counseling codes).

Instead, the wording for 93241 and 93245 tells you to apply the codes for 鈥渕ore than鈥 a minimum time limit and 鈥渦p to鈥 a maximum time limit. From that, you can infer that the extra hours in your scenario lift you over the maximum threshold for 93241 and into the range for 93245, which is the code you should use in your encounter.