93224-93226: Three Holter Monitor Codes Likely To Get A Slight Boost In Pay

By Author: erinarticle
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You have to make the request for your much-deserved dollars.


Medicare's April update to the physician fee schedule brings a little good news what with three Holter monitor codes likely to get a slight boost in pay. The change has an implementation date of April 4, 2011 and an effective date of January 1, 2011. This means contractors have to be all geared up to comply with the change by April 4; however the change in practice expensive relative value units (PE RVUs) is retroactive to January 1 DOS.


Plan: Medicare is not requiring contractors to search their files to adjust claims they have already paid (this is good tidings for any doctor who reports a code seeing a fee decrease). But then contractors do have to adjust claims if you bring them to their attention. You should take a look at how many 93224-93227 services you provided from January to March to check if making the claim for the small increase in RVUs is worth your time.


93224: The PE relative value units for 93224 will change from 2.30 to 2.53. This is a difference of .23 relative value units. By ...
... multiplying that by the 2011 conversion factor (33.9764), you can expect about an additional $7.81 for this code.


93225: For this code, the PE RVUs only increase by .09, shifting from 0.82 to 0.91. Therefore, the additional reimbursement should be around $3.06.


93226: For 93226, you may witness an additional $4.76; its PE relative value units change from 1.21 to 1.35.


If you ever code 93503, the news isn't as nice as this code will see a decrease in PE relative value units, from 0.77 to 0.73(meaning a decrease of about $1.36 per service).


For more on this and for other specialty-specific articles to assist your cardiology coding, sign up for a good medical coding resource like Coding Institute.
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