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As it is said in the medical industry: new year, new CPT codes. With each new year, medical professionals are given a handful of changes to the list of CPT codes, and with regard to the Insertable Cardiac Monitors Coding Guide, CPT codes have been recently deleted and released to update reporting through various services, such as Medicare.
What is an Insertable Cardiac Monitor Used For?
If a patient experiences unexplained fainting, a doctor may prescribe an insertable cardiac monitor. An insertable cardiac monitor (ICM) is a small implantable device that continuously monitors heart rhythms and records them automatically, allowing physicians to download information from the monitor to assist with determining whether fainting is caused by an irregular heartbeat. The device is implanted beneath the skin in the upper chest area through a minimally-invasive procedure.
CPT Code Changes
Effective January 1st, the code designed for the technical component of remote monitoring for Implantable Cardiovascular Physiologic Monitoring Systems and Implantable/Insertable Cardiac Monitors (ICMs), CPT Code 93299, has been deleted. The Centers for Medicare and Medicaid Services have implemented a new G-Code, labelled G2066, to report on this service. G2066 can be reported by physicians and outpatient hospitals. It is to be noted that G2066 will continue to be carrier-priced as 93299 was.
Variation in Codes:
- Interrogation device evaluation(s), (remote) up to 30 days; subcutaneous cardiac rhythm monitor system, including analysis of recorded heart rhythm data, analysis, review(s) and report(s) by a physician or other qualified health care professionals.
- Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results.
The variation noted comes from code G2066 allowing for technicians to review the results from the ICM. This transition from physician-only review provides the physician with the ability to provide an increased amount of implants for patients and less wait time for patient results to be processed, reviewed and diagnosed. Overall, we can assess that with the increase in procedure implant possibilities, therefore increasing device purchase and use. From a market perspective, this change in CPT codes & overall process will affect device sales.
The U.S. cardiac rhythm management market is being driven by the aging population and the increasing incidence of cardiovascular disease. Cardiovascular disease is much more prevalent among patients over 55 years of age; thus, as the U.S. population ages, the incidence of cardiovascular disease will increase. This market is also growing due to the improved ability to diagnose and treat cardiac arrhythmias. As the technology to diagnose arrhythmias such as microvolt T-wave alternans (MTWA), Holter and event monitors improves, the number of patients diagnosed with arrhythmias will continue to increase. Although Abbott has been the market leader for Insertable Cardiac Monitors, as projections continue to process, we have seen Boston Scientific take over as much market as Abbott in 2021, however, as the procedures numbers continue, it is projected that Boston Scientific will overtake Abbott by 2023 and onwards.
For Further Information
More on the cardiac rhythm management market can be found in a series of reports published by iData entitled the U.S. Market Report Suite for Cardiac Rhythm Management Devices