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Cardiographics Testing and Monitoring

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Cardiographics Testing and Monitoring Cardiographics Testing and Monitoring Electrocardiogram (ECG) ECG is a device used to record on graph paper the electrical activity of the heart. The picture is drawn by a computer from information supplied by the electrodes. Your doctor uses the ECG to: • Assess your heart rhythm • Diagnose poor blood flow to the heart muscle (ischemia) • Diagnose a heart attack • Diagnose abnormalities of your heart, such as heart chamber enlargement and abnormal electrical conduction Preparation Instructions: • Avoid oily or greasy skin creams and lotions the day of the test. They interfere with the electrode-skin contact • Avoid full-length hosiery, as electrodes need to be placed directly on the legs. • Wear a shirt that can be easily removed to place the leads on the chest. What to expect During a resting ECG, a technician will attach 10 electrodes with adhesive pads to the skin of your chest, arms and legs. Men may have chest hair shaved to allow a better connection. You will lie flat while the computer creates a picture, on graph paper, of the electrical impulses traveling through your heart. It takes about 10 minutes to attach the electrodes and complete the test, but the actual recording takes only a few seconds. Your ECG patterns will be kept on file for comparison with future ECG recordings. If you have questions, ask your doctor. Cardiac Monitors Cardiac monitors are small, portable electrocardiograph machines that are able to record the heart’s rhythm. Each type of monitor has unique features related to length of recording time and ability to send the recordings over the phone. Your doctor uses ambulatory monitors to: • Assess your heart rhythm over time. • Correlate your symptoms with your heart rhythm. • Diagnose abnormal heart rhythms: what kind they are, how long they last, and what may cause them. • Guide treatment for abnormal heart rhythms. Preparation Instructions: • Avoid oily or greasy skin creams and lotions where the monitor is applied. They interfere with the contact between the electrode and your skin. • Wear a shirt that can be easily removed, so that electrodes can easily be placed on your chest. Holter Monitor (Ambulatory ECG) • A Holter monitor is a portable ECG recorder that you wear during your normal daily activities, including sleeping. • It can be worn up to 48 hours. • Electrodes (sticky patches) are placed on the skin on your chest. Wires are attached from the electrodes to a box about the size of a portable tape player and worn on a belt or shoulder strap. The electrical impulses are continuously recorded and stored in the Holter monitor. • While you are wearing the monitor, you will be asked to keep a diary of your activities and your symptoms, such as fluttering feelings in your chest (palpitations), rapid heartbeats, and any episodes of dizziness or feeling faint. It’s important to keep track of the activities you were doing when your symptoms occurred, so that your doctor can see what kinds of events are causing the symptoms. • When the Holter monitor test is complete, you will return the device. A technician plays the tape on a special computer that analyzes the recording and looks for any abnormalities in your rhythm. The technician prepares a full report for the doctor, including a printout of abnormal heart rhythms. Event Monitor (Event Recorder) • This device, similar to a Holter monitor, is worn during normal daily activities (including sleeping) but is worn for a longer period of time. You will learn how to take the device off during showers and baths. It is used for arrhythmias that occur infrequently. • Small electrodes are attached to your chest. Wires are attached from the electrodes to a box about the size of a portable tape player and worn on a belt or shoulder strap. • When you feel symptoms, you press a button and the recorder is activated. The monitor records the event for the 60 seconds prior to your pushing the button and up to 40 seconds after the arrhythmia is over. The event monitor can store up to three events. • The rhythm can be sent immediately or saved and transmitted later over the phone line. The technician will give the recordings to your doctor for review. If the reading indicates an emergency, the technician will instruct you to go to the emergency room. CardioNet (Mobile Cardiac Outpatient Telemetry) • CardioNet mobile telemetry allows continuous heartbeat monitoring as you go about your daily activities. Most people are on the CardioNet service from seven to 14 days. • This device consists of a small sensor attached to three electrode pads, worn either as a lavalier, which is invisible under clothing or on a belt clip. • The sensor sends each heartbeat to a handheld monitor that can be tucked into a pocket or purse. • When the monitor detects a heart rhythm problem — whether you feel it or not — it automatically transmits your ECG to the CardioNet monitoring center. At the CardioNet center, which operates around the clock, certified cardiac technicians analyze each transmission, respond appropriately to each event, and transmit diagnostic reports to your doctor. • If you feel a symptom, use the touch screen on the CardioNet monitor to report it. The monitor transmits the symptom you entered and your ECG to the CardioNet monitoring center. Integrated symptom and ECG data can help doctors determine or rule out cardiac causes for symptoms such as dizziness and fainting..
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  • Medical Policy
    bmchp.org | 888-566-0008 wellsense.org | 877-957-1300 Medical Policy Ambulatory Cardiac Monitors (Excluding Holter Monitors) Policy Number: OCA 3.35 Version Number: 24 Version Effective Date: 03/01/21 + Product Applicability All Plan Products Well Sense Health Plan Boston Medical Center HealthNet Plan Well Sense Health Plan MassHealth Qualified Health Plans/ConnectorCare/Employer Choice Direct Senior Care Options ◊ Notes: + Disclaimer and audit information is located at the end of this document. ◊ The guidelines included in this Plan policy are applicable to members enrolled in Senior Care Options only if there are no criteria established for the specified service in a Centers for Medicare & Medicaid Services (CMS) national coverage determination (NCD) or local coverage determination (LCD) on the date of the prior authorization request. Review the member’s product-specific benefit documents at www.SeniorsGetMore.org to determine coverage guidelines for Senior Care Options. Policy Summary The Plan considers the use of ambulatory cardiac monitors in the outpatient setting to be medically necessary if the type of ambulatory cardiac monitor is covered for the Plan member and ALL applicable Plan criteria are met, as specified in the Medial Policy Statement and Limitations sections of this policy. Plan prior authorization is required. When the device is covered for the member, medically necessary ambulatory cardiac monitors utilized in the outpatient setting may include ambulatory cardiac event monitors, mobile cardiac outpatient telemetry, and/or single-use external ambulatory electrocardiographic monitoring patches available by prescription. Ambulatory Cardiac Monitors (Excluding Holter Monitors) + Plan refers to Boston Medical Center Health Plan, Inc. and its affiliates and subsidiaries offering health coverage plans to enrolled members.
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