Harvard Pilgrim is updating our Cardiac Event Monitors Medical Policy to include additional supporting information and age- and device-specific coverage criteria and to allow coverage for two additional CPT codes related to mobile cardiac outpatient telemetry.
After a review of clinical literature, Harvard Pilgrim considers mobile cardiac outpatient telemetry medically necessary for certain indications in patients who meet the criteria outlined in the policy. For dates of service beginning July 1, 2017, the following CPT codes will be covered:
- 93228 — Wearable mobile cardiovascular telemetry with electrocardiographic recording, concurrent computerized real time data analysis and greater than 24 hours of accessible ECG data storage (retrievable with query) with ECG triggered and patient selected events transmitted to a remote attended surveillance center for up to 30 days; physician review and interpretation with report
- 93229 — Technical support for connection and patient instructions for use, attended surveillance, analysis and physician prescribed transmission of daily and emergent data reports
Prior authorization is not required. Please refer to the updated Cardiac Event Monitors Medical Policy for complete coverage criteria.