CPT code for Tilt Table Eval.

[Guest guest]

Forwarded Question:

Currently our Out-Patient facility is performing Tilt Table testing for a

local Neurologist. What CPT code should be used and what would be an

appropriate charge.

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Answer:

,

Below is an example of a Medicare carrier local medical review policy addressing

the subject. It may be found at the following web address:

http://www.lamedicare.com/provider/medpol/tilttest.aspMedicare Part B Medical

Policy

It identifies CPT Code 93660 for this particular policy. The CPT 2002 manual

definition of 93660 also refers to codes 95921-95923 for testing autonomic

nervous system function. You chould check with your payers to determine their

coverage policy for this particular service.

The recently published Medicare physicians fee schedule (available on the

PTManager website) indicates the Medicare allowable fee. This could be a good

starting point for establishing your charge.

E. Ciolek, PT, MS, GCS

Wilmington, DE

SUBJECT: TILT TABLE EVALUATION

POLICY NUMBER:

DESCRIPTION:

Tilt table testing consists of the positioning of a patient on a motorized tilt

table which can quickly move the patient from the supine position to an upright

angle of 45-80 degrees and hold the patient in this position for an extended

time period. During the test, heart rate and blood pressure are monitored. An

intravenous line may be used for delivery of pharmacologic agents.

POLICY TYPE: Local medical necessity policy

HCPCS SECTION

& BENEFIT CATEGORY: Medicine; Cardiovascular

HCPCS CODES©: 93660

HCFA's NATIONAL POLICY:

- Title XVIII of the Social Security Act, section 1862 (a) (7). This section

excludes routine physical examinations.

- Title XVIII of the Social Security Act, section 1862 (a) (1) (A). This section

allows coverage and payment for only those services that are considered to be

medically reasonable and necessary.

INDICATIONS & LIMITATIONS OF COVERAGE AND/OR MEDICAL NECESSITY:

This is a covered Medicare B service for patients with recurrent syncope or

arrhythmias that demonstrate medication tolerance problems.

ICD-9 CODES THAT SUPPORT MEDICAL NECESSITY:

780.2, 427.0-427.9

REASONS FOR DENIAL:

There is no literature to support the efficacy of this procedure for any

indications other than those listed above.

NONCOVERED ICD-9 CODES: All others not listed above.

SOURCES OF INFORMATION:

Physicians' Current Procedural Terminology (CPT);

TEC (Med 93660.0 - 04/1993);

This policy was developed in conjunction with our Medical Services Review

Committee (10/1991) which consists of primary care and relative specialties

(LAMSRC Item 91-3).

CODING GUIDELINES:

93660 - Evaluation of cardiovascular function with tilt table evaluation, wtih

continuous ECG monitoring and intermittent blood pressure monitoring, with or

without pharmacological intervention

This policy does not take precedence over the Correct Coding Initiative (CCI)

and CCI does not interfere with Indications/Limitations or acceptable diagnoses

specified.

DOCUMENTATION REQUIREMENTS:

OTHER COMMENTS: Medicare Providers' News LA96-05 and LA93-06; Investigational

prior to 10/02/1991

CAC NOTES:

START DATE OF COMMENT PERIOD: 09/13/1991

START DATE OF NOTICE PERIOD:

11/15/1996

06/01/1993

EFFECTIVE DATE: 10/02/1991

REVISION DATE:

REVISION NUMBER:

" CPT codes, descriptions, and other data only are copyright 1999 American

Medical Association (or such other date of publication of CPT). All Rights

Reserved. Applicable FARS/DFARS Apply. "

[Guest guest]

Currently our Out-Patient facility is performing Tilt Table testing for a

local Neurologist. What CPT code should be used and what would be an

appropriate charge.