Blue Care Network updates authorization guideline for external ECG monitoring

Blue Care Network has updated its authorization guideline for external electrocardiographic monitoring devices that are used for continuous recording and storage of data on a long-term basis (greater than 48 hours), such as Zio Patch^® and LifeStar ACT.

Effective immediately, the following procedure codes no longer require clinical review for either BCN HMO^SM or BCN Advantage^SM members when the services are ordered and provided by a cardiologist:

• *0295T
• *0296T
• *0297T
• *0298T

In addition, plan notification for this service is not required. However, cardiologists in the East and Southeast regions must have an active global referral on file for BCN HMO (commercial) members.

Patients are still expected to meet the criteria for coverage, which specify that external ECG monitoring is an alternative to Holter monitoring in patients.

Read more about these criteria and get additional information in the article Blue Care Network updates authorization guideline for external ECG monitoring, on page 44 in the May-June 2017 issue of BCN Provider News.

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2016 American Medical Association. All rights reserved.

Posted: May 2017
Line of business: Blue Care Network