Frequently Asked Questions
Q. How often should an ICD be checked?
A. Most remote capable devices should be actively monitored continuously. At a minimum, the device should upload all of its current device parameters and settings including battery voltage and lead impedance once per every 90 days. Other arrhythmia or device related triggers can also be programmed to automatically be sent immediately upon occurrence. This remote monitoring is separate from a “in person interrogation” or reprogramming that would take place in a medical facility. Separate billing codes are used for in person interrogation or reprogramming services.
Q. What is the technical CPT code for remote ICD monitoring?
A. The technical CPT code for remote ICD monitoring covers any and all transmissions (scheduled and unscheduled) for each 90 day period. CPT code 93296 should be billed 4 times per year for routine remote ICD monitoring.
Q. What is the professional CPT code for remote ICD monitoring?
A. The professional CPT code for remote ICD monitoring covers the review and physician interpretation for all transmissions that take place within a 90 day period. CPT 93295 should be billed in conjunction with CPT 93296 on a schedule of 4 times per year.
Q. If a patient has 15 captured arrhythmias in a given billing cycle, how many times is the technical CPT code billed?
A. Remote pacemaker and ICD monitoring is covered by a temporal billing period. That means that any and all transmissions that take place within a given period of time are covered under a single set of remote billing codes. Therefore, CPT 93296 would be billed only once on day 91, regardless of the total transmissions or reports that were reviewed during that billing period.
Q. If a patient does not transmit any device data within a 90 day period, can you bill for the physician interpretation?
A. It is vital to make sure that each patient has a remote transmission scheduled for each monitoring period. In addition, it is wise to set up a manual or automated reminder system so that each patient transmits in a timely manner. If no transmissions are received during the scheduled period, billing must be delayed until a manual or automatic transmission can be sent and reviewed. If this takes place past day 91, all subsequent billing dates must be revised with the new schedule to maintain the new 90 day cycle.
Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead implantable defibrillator system with interim analysis, review(s) and report(s) by a physician or other qualified healthcare professional.
Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead pacemaker system, leadless pacemaker system, or implantable defibrillator system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results.