2025 CPT code 93294
(Active) Effective Date: N/A Revision Date: N/A Diagnostic - Cardiac Device Evaluation Medicine Services and Procedures > Cardiovascular Procedures Feed
Remote interrogation device evaluation of a pacemaker or implantable cardioverter-defibrillator (ICD) system for up to 90 days, including analysis, review, and report by a qualified healthcare professional.
Modifiers may be applicable depending on the specific circumstances of the service. Consult the CPT manual and payer guidelines for appropriate modifier usage.
Medical necessity is established when remote monitoring is deemed clinically appropriate to ensure the proper functioning of a pacemaker or ICD system, detect potential malfunctions, and optimize patient care. This may include situations where in-person evaluations are not feasible or when continuous monitoring is needed to address specific clinical concerns.
The clinical responsibility lies with the physician or qualified healthcare professional who analyzes the transmitted data, assesses the pacemaker's function and safety, and prepares a report for the patient's care team.
In simple words: The doctor or a qualified healthcare professional remotely checks on your pacemaker or implantable defibrillator for up to 90 days.They review the data sent from the device, check that it is working correctly, and send a report to your doctor.
This CPT code encompasses the remote monitoring and analysis of a pacemaker or implantable cardioverter-defibrillator (ICD) system's function over a period not exceeding 90 days.The evaluation includes data transmission, analysis of device performance (including programmed parameters, leads, battery function, capture and sensing capabilities, and underlying heart rhythm), review of findings, and generation of a report for the physician or qualified healthcare professional.The system may be a single, dual, multiple lead, or leadless pacemaker system.
Example 1: A patient with a newly implanted pacemaker undergoes remote monitoring for 90 days post-implantation to ensure proper function and detect any potential issues., A patient experiencing intermittent dizziness and suspected pacemaker malfunction undergoes a 90-day remote monitoring period to evaluate device performance and identify the cause of symptoms., A patient with a long-standing pacemaker requires routine remote monitoring to assess battery life and device function as part of ongoing preventative care.
Documentation should include patient demographics, device information, dates of service, transmitted data, analysis results, and the final report generated by the qualified healthcare professional.
** The 90-day monitoring period should be considered a guideline.Payers may have specific requirements or limitations for reimbursement. Always refer to the most current CPT manual and payer guidelines for accurate coding and billing practices.
- Revenue Code: T2D (OTHER TESTS - OTHER)
- RVU: RVUs will vary based on geographic location and other factors. Consult your local payer for specific reimbursement rates.
- Global Days: This code is reported only once per 90-day period; the monitoring period must be at least 30 days.Do not report if the monitoring period is less than 30 days.
- Payment Status: Active
- Modifier TC rule: Technical Component (TC) modifiers are not applicable to this code as it represents a professional service.
- Fee Schedule: Historical fee schedules vary widely based on payer, location, and year of service.Refer to historical payer data for specific information.
- Specialties:Cardiology, Cardiac Electrophysiology
- Place of Service:Office, Hospital, Other Remote Monitoring Center