Ambulatory Electrocardiograph (AECG) Monitoring

Medically necessary AECG monitoring requires use of an FDA-cleared device and is covered when a standard 12-lead ECG, cardiac history, and exam do not explain cardiac complaints and monitoring is expected to change management, or for specific indications such as unexplained syncope, palpitations, bradycardia, nocturnal arrhythmias, atrial fibrillation rate assessment, post-therapy evaluation, post-ACS prognosis, ICD reprogramming, evaluation for silent ischemia, or assessment of ventricular ectopy in specified cardiomyopathies. Devices without FDA clearance (including smartphone/handheld devices), monitoring of ventricular arrhythmias that require inpatient care, and 24-hour monitoring stations that do not meet the LCD staffing/physician-access definition are not covered. Documentation must include prior 12-lead ECG, complete cardiac history/exam, device clearance and labeled indications, appropriate provider licensure/training, and for mobile telemetry evidence of a 24/7 staffed receiving station with immediate physician access.