Allied Professionals Community of Practice

  • 1.  Billing Questions

    Posted 03-27-2025 15:18

    I have a couple of questions regarding billing.

    1)      If your clinic has a patient that does not want to do remote monitoring and is nearing ERI and needs to be checked monthly (in office) - do you charge monthly for those in office checks or waive that charge to every three months, not at all, etc.?

    2)      If your clinic has a patient that is on remote monitoring but must send a manual transmission every three months (not a wireless device). Do you continue to bill the remote checks every three months and bill for the annual office check. Or do you skip one of the remote checks and only bill for the office check. Particularly if it is on the same day.

    Thank you for your input.



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    Mary Jo Goddard BSN, RN
    University Cardiology
    Knoxville TN
    [Phone]
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  • 2.  RE: Billing Questions

    Posted 03-27-2025 17:10

    HI Mary Jo,

     

    You can bill for an in-office check every time you need to see the patient, as long as the reason for the visit is documented, ie: battery check, nearing ERI.  There is no 91 day  lock out for in-office checks. 

    **Caveat:  IF you are only checking the battery and you do not run any tests, you can only bill for "interrogation without programming changes".

    **Second caveat:  If you are billing for remote monitoring every 91 days, you cannot bill for an "in-office without programming changes" (because that is the same info you get with a remote transmission). You can only bill for "in office with iterative programming changes" for pts using remote monitoring.

     

    If the patient is sending monthly remotes for any reason, which we also do for our manual transmission patients nearing ERI, you can ONLY bill one charge every 91 days. 

     

    Hope this makes sense, if not, happy to discuss on a call. 

     

    Sallie Gustafson, BSN, CCDSs

    Senior Manager, Clinical Services and Operations

    Emory Cardiac Device Clinics

    Office:  (404) 778-4942

     




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