2025 CPT code 93260
(Active) Effective Date: N/A Revision Date: N/A Cardiology - Implantable Cardiac Device Evaluation Medicine Services and Procedures > Cardiovascular Procedures Feed
In-person programming device evaluation of an implantable subcutaneous lead defibrillator system, with iterative adjustments to optimize device settings.
Modifiers may apply depending on the circumstances.For example, modifier 26 (professional component) could be used if only the professional services are billed.
Medical necessity is established by the need for device interrogation, troubleshooting, and reprogramming to optimize device function, prevent complications, and ensure patient safety.Evidence may include symptoms suggestive of device malfunction, abnormal device data, or the need for post-procedural device adjustment.
The physician or other qualified healthcare professional evaluates the implanted device, tests its functionality, makes necessary adjustments to programming parameters, reviews the data, and prepares a comprehensive report.
In simple words: The doctor checks and adjusts the settings of your implanted defibrillator to make sure it's working correctly and is set to provide the best possible protection for your heart.
This CPT code encompasses an in-person evaluation and programming of an implantable subcutaneous lead defibrillator system.The procedure involves iterative adjustments of programmable parameters (e.g., pacing output) to assess capture thresholds and determine optimal settings.The evaluation includes a comprehensive analysis of device function, lead integrity, battery status, and rhythm data, culminating in a report detailing the findings and final programmed parameters.
Example 1: A patient presents for a routine follow-up of their recently implanted subcutaneous ICD. The physician performs a 93260, evaluating lead impedance, battery function, and sensing capabilities.Programming adjustments are made to optimize the device's responsiveness to arrhythmias. A detailed report is generated., A patient experiencing symptoms consistent with ICD malfunction schedules a visit. The physician performs a 93260, identifying a high R-wave amplitude.Adjustments are made to the sensitivity settings to reduce inappropriate shocks. Post-programming testing confirms resolution of the issue., Following a cardiac surgery, a patient's subcutaneous ICD requires reprogramming to accommodate the changes in heart function and activity levels. The physician performs a 93260, carefully adjusting pacing parameters to ensure adequate support.
Detailed patient history, device interrogation data (including pre- and post-programming parameters), ECG tracings, physician's interpretation and analysis of the data, and final report documenting the evaluation and any changes made.
** Always refer to the most current CPT codebook and payer guidelines for accurate coding and reimbursement.This information is for guidance only and should not be considered definitive medical advice.
- Revenue Code: T2D - OTHER TESTS - OTHER
- RVU: This information is not available in the provided text.Consult the current CPT codebook and associated fee schedules for RVU data.
- Global Days : Not applicable for this code. Global periods are associated with surgical procedures, not device evaluations.
- Payment Status: Active
- Modifier TC rule: Modifier TC (Technical Component) is not typically used with 93260 as it generally represents the physician's professional interpretation and programming adjustments.
- Fee Schedule : This information is not available in the provided text.Consult the relevant fee schedules for historical data.
- Specialties:Cardiology, Cardiac Electrophysiology
- Place of Service:Office, Hospital, Ambulatory Surgical Center