2025 CPT code 93285
(Active) Effective Date: N/A Revision Date: N/A Cardiology - Cardiac Device Evaluation Medicine Services and Procedures > Cardiovascular Procedures Feed
In-person programming device evaluation with iterative adjustments to test device function and select optimal programmed values, including analysis, review, and report.
Modifiers 26 (professional component) and 59 (distinct procedural service) may be applicable in certain circumstances.Consult the most recent CPT guidelines for appropriate modifier usage.
Medical necessity is established by the presence of symptoms or evidence of device malfunction requiring adjustments to device settings.The physician's clinical judgment should support the need for iterative adjustments to optimize device function and therapy delivery. Documentation should support the clinical indication for this procedure.
The physician or other qualified healthcare professional is responsible for connecting the patient to an ECG monitor, establishing communication with the device programmer, analyzing stored and current data, making iterative adjustments to device settings, retesting device function, determining the need for programming changes, and preparing a report.
In simple words: The doctor or a qualified healthcare professional directly examines and adjusts the settings of an implanted heart device (pacemaker, defibrillator, or cardiac rhythm monitor) to ensure it works correctly. They test the device, make changes to optimize its function, and then provide a report of their findings.
This CPT code encompasses an in-person programming device evaluation for pacemakers, implantable defibrillators, or subcutaneous cardiac rhythm monitors.The evaluation involves iterative adjustments of programmable parameters to test device function and select the most appropriate final programmed values. This process includes analysis of retrieved data, review of device functions (including battery, lead(s), capture and sensing), and the preparation of a report by a physician or other qualified healthcare professional.Iterative adjustments may include changes to sensor rate response, heart rate limits, AV intervals, pacing voltage and pulse duration, sensing values, and diagnostics. For implantable defibrillators, this may also involve adjustments to ventricular tachycardia detection and therapies.
Example 1: A patient with a newly implanted pacemaker undergoes a post-implantation programming evaluation to optimize pacing parameters and ensure proper device function. The physician performs iterative adjustments to capture thresholds and other settings., A patient with an implantable cardioverter-defibrillator (ICD) experiences a malfunction.The physician performs an in-person interrogation and programming evaluation to troubleshoot the issue, making iterative adjustments to the device’s settings to restore proper function and optimize therapy delivery., A patient with a subcutaneous implantable defibrillator (SICD) requires adjustments to the device's detection and therapy parameters. The physician conducts a programming evaluation, making incremental changes to settings based on the patient's clinical status and device performance data, to fine-tune the device's response to ventricular tachyarrhythmias.
Detailed patient history, including symptoms, medications, and any prior device-related issues.Pre- and post-programming device readings.Documentation of iterative adjustments made to device settings, including rationale for each adjustment.Physician's interpretation of the data and final programmed parameters. A copy of the report generated after the procedure.
** This code should only be reported by a physician or other qualified healthcare professional who directly performs the programming evaluation and iterative adjustments.The service is not separately billable from device implantation or revision services performed by the same individual on the same date.
- Revenue Code: T2D (OTHER TESTS - OTHER)
- Payment Status: Active
- Modifier TC rule: The technical component (TC) modifier is not applicable to this code as it represents both the professional and technical components of the service.
- Specialties:Cardiology, Cardiac Electrophysiology
- Place of Service:Office, Hospital, Ambulatory Surgical Center