Billing and Coding: Temporary Nontherapeutic Ambulatory Cardiac Monitoring Devices

Coverage for temporary nontherapeutic ambulatory cardiac monitoring devices is governed by the reasonable and necessary criteria in LCD DL40244 and subject to national coding edits (CCI/NCCI/OPPS). Claims must include a valid ICD-10-CM diagnosis, required ordering/referring physician identifiers when applicable, and medical record documentation (assessment, history, test results, signed visit/operative notes); ABN modifier rules (GA, GX, GZ, GY) and occurrence code 32 requirements apply for anticipated non-coverage situations.

"Coverage for temporary nontherapeutic ambulatory cardiac monitoring devices is determined by the reasonable and necessary requirements in LCD DL40244 and associated medical necessity criteria."

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