Electrocardiographic (EKG or ECG) Monitoring (Holter or Real-Time Monitoring)
L34636
External ECG monitoring (Holter, event monitors, and 30-day telephonic monitoring) is covered when listed medical necessity indications are documented, including specific symptoms (e.g., palpitations, syncope, chest pain), evaluation of antiarrhythmic therapy, post-MI with EF ≤ 40%, CAD with active symptoms, ischemic heart disease, or post-ablation surveillance. Standard durations include 24-hour Holter, 48-hour recordings, extended continuous monitoring >48 hours up to 7 or up to 15 days in selected patients, and 30-day telephonic (24-hour attended) monitoring; event monitors are appropriate for infrequent symptoms occurring less frequently than every 48 hours. Telephonic 30-day codes represent 24-hour attended monitoring per 30-day period and cannot be billed concurrently with other EKG monitoring codes; providers should document indications, symptom frequency, and EF (when applicable) and follow current CPT coding guidance.
"External 48-hour ECG recording is indicated for patients with one or more of the following: arrhythmias, chest pain, syncope (or near syncope), vertigo (dizziness), palpitations, transient ischemic..."