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2025 CPT code 93261

In-person interrogation and evaluation of an implantable subcutaneous lead defibrillator system, including connection, recording, disconnection, analysis, review, and report.

Follow CPT guidelines for cardiac device evaluation services. Refer to the specific guidelines for 93261 within the CPT codebook for detailed instructions on appropriate use and limitations.

Modifiers 26 (Professional Component), 51 (Multiple Procedures), and others may apply depending on the specific circumstances of the service.Consult CPT guidelines for modifier application rules.

Medical necessity is established by the need to assess the proper function of the subcutaneous ICD. This includes checking battery life, lead integrity, and overall device performance.Symptoms suggestive of malfunction, planned procedures requiring device adjustments, and routine follow-up evaluations can support medical necessity.

The provider interacts directly with the patient to evaluate the previously placed subcutaneous lead defibrillator system.They retrieve and evaluate stored data to determine the device's current programming and assess aspects of its function. They may connect, record, and disconnect the device.A report summarizing findings is generated.

IMPORTANT:Do not report 93261 in conjunction with codes 93260, 93287, 93289, or pulse generator and lead insertion/repositioning codes (33240, 33241, 33262, 33270, 33271, 33272, 33273).

In simple words: The doctor checks a device implanted under your skin to regulate your heartbeat.They look at the device's data and check if it's working correctly, then provides a report.

This CPT code encompasses the in-person interrogation and evaluation of a previously implanted subcutaneous lead defibrillator system.The procedure involves retrieving stored data regarding the lead, battery, and implanted pulse generator function.The provider analyzes this data to determine the device's current programming and evaluates aspects of its function, such as battery voltage and therapy settings.The procedure may also include connecting, recording data from, and disconnecting the device.Finally, the provider prepares a report summarizing their findings.

Example 1: A patient presents with symptoms suggestive of malfunctioning subcutaneous ICD. The physician performs an in-person interrogation to assess the device's functionality, battery life, and lead integrity. The findings are documented in a detailed report., A patient is scheduled for an elective procedure. Before the surgery, the physician conducts an in-person interrogation and programming of the patient's subcutaneous ICD to ensure safe operation during the procedure and to avoid potential conflicts. This is also documented., Post-implantation of a subcutaneous ICD, the physician performs an in-person interrogation to verify proper device function, lead placement, and to optimize programming based on the patient's initial response and clinical status.This is also carefully documented.

* Detailed patient history and symptoms.* Device interrogation data including lead impedance, battery voltage, and programmed parameters.* Documentation of any changes made to device programming.* Physician's interpretation and assessment of the interrogation findings.* A comprehensive report summarizing the procedure and findings.

** This code is specifically for in-person evaluation of subcutaneous lead defibrillator systems.Remote evaluations would be coded differently.Accurate documentation is crucial for proper reimbursement.

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