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2025 CPT code 93644

Electrophysiologic evaluation of subcutaneous implantable defibrillator (S-ICD) system.

Do not report 93644 with 33270 during initial device insertion. Use 93260/93261 for subsequent evaluations, and 0577T for systems with a substernal electrode.

Modifiers may be applicable in certain situations, such as increased procedural services (22), reduced services (52), distinct procedural service (59), repeat procedure by same physician (76), or repeat procedure by another physician (77).

Medical necessity is established based on the patient's condition, symptoms, and the need to evaluate and optimize the S-ICD's function. This could be due to an arrhythmia episode, routine device check, or concerns about the device's performance.

The physician performs the procedure with the patient prepped and possibly anesthetized.A catheter is inserted into the femoral artery and advanced to the heart. Electrical signals are transmitted to determine pacing thresholds and induce arrhythmias.The defibrillator's sensing capabilities are observed, and the threshold for arrhythmia termination is determined. The device may be programmed or reprogrammed.

IMPORTANT:(Do not report 93644 in conjunction with 33270 at the time of subcutaneous implantable defibrillator device insertion)(For subsequent or periodic electrophysiologic evaluation of a subcutaneous implantable defibrillator device, see 93260, 93261)(For electrophysiological evaluation of subcutaneous implantable defibrillator system, with substernal electrode, use 0577T)

In simple words: This procedure tests the function of a defibrillator implanted under the skin (S-ICD). It checks if the device can detect and correct abnormal heart rhythms and if the shock strength is appropriate. The doctor may also adjust the device's settings.

Electrophysiologic evaluation of subcutaneous implantable defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parameters).

Example 1: A patient with an S-ICD experiences an episode of rapid heart rate. Code 93644 is used to evaluate the S-ICD function, including its sensing and shock delivery capabilities, and to ensure appropriate programming., During a routine follow-up, a patient with an S-ICD undergoes an electrophysiologic evaluation using 93644 to assess the device's performance and make any necessary adjustments to the settings., A patient with a newly implanted S-ICD undergoes evaluation with code 93644 to establish baseline device parameters and ensure proper function.

Documentation should include the details of the electrophysiologic evaluation, including the type and method of arrhythmia induction, defibrillation threshold measurements, sensing parameters, and any programming or reprogramming performed. The medical necessity for the procedure should also be documented, such as symptoms, previous episodes, or routine device check.

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