Billing and Coding: Temporary Nontherapeutic Ambulatory Cardiac Monitoring Devices

Billing and coverage for temporary nontherapeutic ambulatory cardiac monitoring devices are conditional on meeting the reasonable and necessary requirements of LCD DL40255. Claims must include a valid ICD-10-CM diagnosis code, required documentation (assessment, history, test results, signed notes), and when applicable the referring/ordering physician's name and NPI; modifier and ABN rules (GA/GX/GZ/GY) and coding edits (CCI/NCCI/OPPS) apply and may result in automatic denials.

"Temporary nontherapeutic ambulatory cardiac monitoring devices (TNACMD) are covered only when the use meets the reasonable and necessary requirements specified in LCD DL40255."

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