2025 CPT code 93286
(Active) Effective Date: N/A Revision Date: N/A Cardiology - Pacemaker/Implantable Defibrillator Evaluation and Programming Medicine Services and Procedures > Cardiovascular Procedures Feed
Peri-procedural device evaluation and programming of pacemaker parameters before, during, or after a procedure.
Modifiers 26 (professional component), 51 (multiple procedures), and 59 (distinct procedural service) may be applicable depending on the circumstances of the service.Refer to the CPT manual for guidance on modifier use.
Medical necessity for code 93286 is established when the physician needs to adjust pacemaker parameters before, during, or after a procedure to ensure the device functions safely and effectively during and after the intervention.This is particularly important during procedures that could interfere with the pacemaker's operation or that may cause changes in the patient's cardiac rhythm.
A physician or other qualified healthcare professional is responsible for establishing communication with the pacemaker, reviewing stored data, adjusting parameters, re-interrogating the device, documenting the changes, and ensuring appropriate device functionality before, during, or after a planned intervention.The clinician must be qualified by education, training, and licensure/regulation and facility privileging where applicable.
- Medicine Services and Procedures > Cardiovascular Procedures
- Cardiovascular Procedures; Pacemaker/Implantable Defibrillator Evaluation and Programming
In simple words: The doctor checks and adjusts the settings of a pacemaker before, during, or after a medical procedure like surgery. They connect to the pacemaker, check its data, make any needed adjustments, and then check again to make sure the changes are correct.The doctor writes down what they did.
This CPT code 93286 represents the technical and professional components of a peri-procedural device evaluation and programming service for a single, dual, multiple-lead, or leadless pacemaker system.A qualified healthcare professional establishes communication with the pacemaker, reviews stored data parameters, modifies one or more parameters as needed, and re-interrogates the device to confirm the programming changes. This process occurs before, during, or after a surgery, procedure, or test.The provider documents all changes made.If both pre- and post-procedure evaluations are performed by the same individual, code 93286 is reported twice. If performed by different individuals, each reports the code once.
Example 1: A patient is scheduled for cardiac ablation. Before the procedure, the electrophysiologist performs a peri-procedural device evaluation and programming of the patient's dual-chamber pacemaker to temporarily adjust parameters to ensure safe operation during the ablation procedure. After the ablation, the electrophysiologist restores the pacemaker to its original settings., A patient with a single-chamber pacemaker undergoes a surgical procedure.Prior to surgery, the cardiologist performs a peri-procedural device evaluation and programming, adjusting settings to accommodate the surgery. Post-surgery, the cardiologist performs another evaluation and programming session to return the pacemaker to its pre-surgical settings., A patient with a leadless pacemaker requires a change in pacing parameters due to changes in their clinical status. The cardiologist performs a comprehensive interrogation and makes the necessary adjustments before and after making the parameter change.
Detailed documentation should include the pre-procedural pacemaker settings, the changes made during the peri-procedural evaluation and programming, the post-procedural pacemaker settings, and a justification for any parameter changes. The documentation should also include the type of pacemaker (single, dual, multiple-lead, or leadless), the reason for the procedure or test, and the patient's response to the changes in pacemaker settings.
** This code encompasses both the technical and professional components.The same individual may not perform both a pre- and post-procedural evaluation and programming on the same day.Refer to the complete CPT manual for detailed instructions and guidelines.
- Revenue Code: T2D (OTHER TESTS - OTHER)
- Payment Status: Active
- Modifier TC rule: Modifier TC (technical component) is not applicable to 93286 as this code includes both professional and technical components.
- Specialties:Cardiology, Cardiac Surgery, Electrophysiology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center, Office