How To Use CPT Code 93280

CPT 93280 refers to the in-person programming device evaluation and iterative adjustment of a dual lead pacemaker system by a physician or qualified healthcare professional. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 93280.

1. What is CPT 93280?

CPT 93280 is a medical billing code used to describe the in-person programming device evaluation and iterative adjustment of an implanted dual lead pacemaker system. This code is used when a physician or other qualified healthcare professional performs a face-to-face evaluation of the pacemaker system and makes necessary adjustments to optimize its performance. The code represents both the professional and technical components of the service.

2. 93280 CPT code description

The official description of CPT code 93280 is: “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; dual lead pacemaker system.”

3. Procedure

The 93280 CPT code procedure involves the following steps:

1. The patient is connected to a single or multilead electrocardiogram (ECG) monitor, establishing a communication link between the pacemaker and the programmer.
2. The physician or qualified healthcare professional analyzes and reviews several parameters of the stored pacemaker data, comparing it to current readings.
3. Based on the analysis, the physician or healthcare professional determines whether to change the programming of the device to optimize its performance.
4. The necessary adjustments are made to the pacemaker system, and the device’s function is tested.
5. The physician or healthcare professional selects the optimal permanent programmed values for the pacemaker system.
6. A report is generated, documenting the analysis, review, and adjustments made to the pacemaker system.

4. Qualifying circumstances

Patients eligible to receive CPT code 93280 services are those with an implanted dual lead pacemaker system that requires evaluation and potential adjustments to optimize its performance. This may include patients experiencing symptoms related to their pacemaker, those with a history of device-related complications, or those undergoing routine follow-up evaluations to ensure the proper functioning of their pacemaker system.

5. When to use CPT code 93280

It is appropriate to bill the 93280 CPT code when a physician or qualified healthcare professional performs an in-person evaluation and iterative adjustment of an implanted dual lead pacemaker system. This may occur during routine follow-up appointments, in response to patient-reported symptoms, or when the device’s performance needs to be optimized for any other reason.

6. Documentation requirements

To support a claim for CPT 93280, the following information should be documented:

• Patient’s medical history, including the indication for the implanted pacemaker system
• Details of the in-person evaluation, including the date and time of the service
• Results of the ECG monitoring and analysis of the stored pacemaker data
• Specific adjustments made to the pacemaker system, including the rationale for each adjustment
• Results of the device function testing after adjustments
• Optimal permanent programmed values selected for the pacemaker system
• A report summarizing the analysis, review, and adjustments made to the pacemaker system

7. Billing guidelines

When billing for CPT code 93280, it is important to follow the appropriate guidelines and rules. Do not report 93280 in conjunction with 93286 or 93288. Additionally, when billing for remote monitoring and trans telephonic monitoring (TTMs), it is not necessary to differentiate between single, dual, or multiple chamber systems. However, in-person programming evaluation represented by code range 93279 to 93285 requires proper identification and reporting of the type of device being evaluated.

8. Historical information

CPT 93280 was added to the Current Procedural Terminology system on January 1, 2009. There have been updates to the code description since its addition, with the most recent change occurring on January 1, 2013.

9. Similar codes to CPT 93280

Five similar codes to CPT 93280 and how they differentiate from CPT 93280 are:

1. CPT 93279: This code is used for the evaluation and adjustment of a single lead pacemaker system, as opposed to the dual lead system in CPT 93280.
2. CPT 93281: This code refers to the evaluation and adjustment of a single lead cardioverter-defibrillator system, which is different from the pacemaker system in CPT 93280.
3. CPT 93282: This code is used for the evaluation and adjustment of a dual lead cardioverter-defibrillator system, which is different from the pacemaker system in CPT 93280.
4. CPT 93283: This code refers to the evaluation and adjustment of a multiple lead cardioverter-defibrillator system, which is different from the dual lead pacemaker system in CPT 93280.
5. CPT 93284: This code is used for the evaluation and adjustment of a multiple lead pacemaker system, as opposed to the dual lead system in CPT 93280.

10. Examples

Here are 10 detailed examples of CPT code 93280 procedures:

1. A patient with a history of atrial fibrillation and an implanted dual lead pacemaker system presents for a routine follow-up evaluation. The physician performs an in-person programming device evaluation and makes necessary adjustments to optimize the pacemaker’s performance.
2. A patient with a dual lead pacemaker system reports experiencing palpitations. The physician performs a CPT 93280 procedure to evaluate the device and make adjustments to alleviate the patient’s symptoms.
3. A patient with a dual lead pacemaker system undergoes a surgical procedure that may have affected the device’s function. The physician performs a CPT 93280 procedure to ensure the pacemaker is functioning optimally postoperatively.
4. A patient with a dual lead pacemaker system presents for a routine follow-up appointment. The physician performs a CPT 93280 procedure to evaluate the device and make any necessary adjustments to maintain optimal performance.
5. A patient with a dual lead pacemaker system experiences syncope. The physician performs a CPT 93280 procedure to evaluate the device and make adjustments to prevent further episodes of syncope.
6. A patient with a dual lead pacemaker system reports shortness of breath during exertion. The physician performs a CPT 93280 procedure to evaluate the device and make adjustments to improve the patient’s symptoms.
7. A patient with a dual lead pacemaker system presents for a routine follow-up appointment. The physician performs a CPT 93280 procedure to evaluate the device and make any necessary adjustments to maintain optimal performance.
8. A patient with a dual lead pacemaker system experiences chest pain. The physician performs a CPT 93280 procedure to evaluate the device and make adjustments to alleviate the patient’s symptoms.
9. A patient with a dual lead pacemaker system undergoes a surgical procedure that may have affected the device’s function. The physician performs a CPT 93280 procedure to ensure the pacemaker is functioning optimally postoperatively.
10. A patient with a dual lead pacemaker system presents for a routine follow-up appointment. The physician performs a CPT 93280 procedure to evaluate the device and make any necessary adjustments to maintain optimal performance.