2025 CPT code 93281
(Active) Effective Date: N/A Revision Date: N/A Medicine - Cardiovascular Procedures Feed
In-person programming device evaluation with iterative adjustment of an implantable multiple lead pacemaker system to test device function and select optimal permanent programmed values, including physician analysis, review, and report.
Modifier 26 may be used to indicate the professional component of the service. Modifier 59 may be used to indicate a distinct procedural service. Other modifiers may be applicable depending on the specific circumstances.
Medical necessity for this procedure is established when the patient's condition requires adjustments to their pacemaker settings to maintain or improve cardiac function. Documentation should support the clinical rationale for the procedure.
The physician or other qualified healthcare professional connects the patient to an ECG monitor, establishes communication with the pacemaker, analyzes stored data and current readings, and adjusts device programming for optimal function. This involves iterative adjustments to test device function and determine the best permanent settings.
In simple words: This procedure involves a doctor adjusting the settings of a pacemaker that has multiple leads.The doctor connects to the pacemaker and tests different settings to find the ones that work best for the patient.They then create a report of the visit and the new settings.
Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; multiple lead pacemaker system. (Use 93281 in conjunction with 0696T when body surface-activation mapping to optimize electrical synchrony is also performed) (Do not report 93281 in conjunction with 93286, 93288)
Example 1: A patient with a multiple lead pacemaker experiences symptoms suggesting suboptimal device function. The physician performs an in-person evaluation, connecting to the device to analyze its performance and adjust settings to alleviate the patient's symptoms. , Following a change in a patient's health status, their existing pacemaker settings require adjustment. The physician performs an in-person programming device evaluation, making iterative adjustments to optimize the pacemaker's response to the patient's current needs. , A patient with a newly implanted multiple lead pacemaker requires initial programming and optimization. During an in-person evaluation, the physician adjusts the device settings iteratively to achieve optimal pacing parameters for the patient's specific anatomy and physiology.
Documentation should include details of the iterative adjustments performed, the rationale for the adjustments, the final programmed parameters, and the patient's response to the changes. Reports of stored device data and ECG readings should also be included.
** As of December 1st, 2024, this information is current.However, medical coding guidelines and reimbursement policies can change. Always verify the latest information with the relevant payers and coding resources like iFrameAI for the most up-to-date details.
- RVU: 1.97 (as of 2019 according to available information)
- Modifier TC rule: Modifier TC is not applicable to this code as it represents both the technical and professional components.
- Specialties:Cardiac electrophysiology, cardiology
- Place of Service:Office, Outpatient Hospital, Inpatient Hospital, Emergency Room - Hospital