How To Use CPT Code 93296

CPT 93296 refers to the remote interrogation device evaluation for single, dual, or multiple lead pacemaker systems, leadless pacemaker systems, or implantable defibrillator systems, covering a period of up to 90 days. This article will discuss the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 93296.

1. What is CPT 93296?

CPT 93296 is a medical billing code used to describe the remote interrogation device evaluation for single, dual, or multiple lead pacemaker systems, leadless pacemaker systems, or implantable defibrillator systems. This code covers the technical component of the service, including data acquisition, receipt of transmissions, technician review, technical support, and distribution of results for a period of up to 90 days.

2. 93296 CPT code description

The official description of CPT code 93296 is: “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.”

3. Procedure

1. A technician uses special equipment and a regular phone line to remotely access and retrieve information stored on a single, dual, multiple lead, or leadless pacemaker system or implantable cardioverter-defibrillator system.
2. The technician evaluates the data received, such as programmed parameters of the device, lead integrity, battery status, certain device settings and conditions including capture and sensing functions, the presence or absence of episodes of irregular rhythms, the underlying heart rhythm, and others.
3. Upon completion of the technical review, the technician sends the results to the patient’s physicians and provides them with any technical support they need.

4. Qualifying circumstances

Patients with single, dual, multiple lead, or leadless pacemaker systems or implantable defibrillator systems are eligible to receive CPT code 93296 services. The monitoring period should be up to 90 days, and the code should not be reported more than once every 90 days. If the monitoring period is less than 30 days, do not report CPT 93296.

5. When to use CPT code 93296

CPT code 93296 should be used when a technician remotely evaluates a patient’s single, dual, multiple lead, or leadless pacemaker system or implantable defibrillator system for a period of up to 90 days. This code represents the technical component of the service only and should not be appended with modifier 26 or TC.

6. Documentation requirements

To support a claim for CPT 93296, the following information should be documented:

• Patient’s demographic information, including name, date of birth, and medical record number
• Type of device being evaluated (single, dual, multiple lead, or leadless pacemaker system or implantable defibrillator system)
• Date and time of remote interrogation
• Duration of the monitoring period
• Results of the technical review, including programmed parameters, lead integrity, battery status, device settings and conditions, capture and sensing functions, presence or absence of irregular rhythms, and underlying heart rhythm
• Any technical support provided to the patient’s physicians

7. Billing guidelines

When billing for CPT code 93296, keep in mind the following guidelines:

• Do not report CPT 93296 more than once every 90 days.
• If the monitoring period is less than 30 days, do not report CPT 93296.
• Do not append modifier 26 or TC to CPT 93296, as it represents the technical component of the service only.
• Do not report CPT 93296 in conjunction with CPT 93288, CPT 93289, 0578T, or 0579T.

8. Historical information

CPT 93296 was added to the Current Procedural Terminology system on January 1, 2009. The code has undergone changes in its descriptor on January 1, 2015, and January 1, 2019.

9. Similar codes to CPT 93296

Five similar codes to CPT 93296 and how they differentiate are:

• CPT 93288: In-person interrogation device evaluation for single, dual, or multiple lead pacemaker systems or implantable defibrillator systems.
• CPT 93289: In-person interrogation device evaluation for implantable loop recorder systems.
• 0578T: Remote interrogation device evaluation for implantable cardioverter-defibrillator with substernal lead.
• 0579T: Remote interrogation device evaluation for implantable cardioverter-defibrillator with substernal lead, including analysis of heart rhythm data.
• CPT 93294: Remote interrogation device evaluation for implantable cardiovascular monitor systems, including analysis of heart rhythm data.

10. Examples

Here are 10 detailed examples of CPT code 93296 procedures:

1. A patient with a single lead pacemaker system undergoes a 60-day remote monitoring period, with the technician evaluating the device’s programmed parameters, lead integrity, and battery status.
2. A patient with a dual lead pacemaker system undergoes a 90-day remote monitoring period, with the technician evaluating the device’s programmed parameters, lead integrity, battery status, and sensing functions.
3. A patient with a multiple lead pacemaker system undergoes a 45-day remote monitoring period, with the technician evaluating the device’s programmed parameters, lead integrity, battery status, and presence or absence of irregular rhythms.
4. A patient with a leadless pacemaker system undergoes a 30-day remote monitoring period, with the technician evaluating the device’s programmed parameters, lead integrity, battery status, and underlying heart rhythm.
5. A patient with an implantable defibrillator system undergoes a 75-day remote monitoring period, with the technician evaluating the device’s programmed parameters, lead integrity, battery status, and capture functions.
6. A patient with a single lead pacemaker system undergoes a 50-day remote monitoring period, with the technician evaluating the device’s programmed parameters, lead integrity, battery status, and device settings and conditions.
7. A patient with a dual lead pacemaker system undergoes an 80-day remote monitoring period, with the technician evaluating the device’s programmed parameters, lead integrity, battery status, and sensing functions.
8. A patient with a multiple lead pacemaker system undergoes a 70-day remote monitoring period, with the technician evaluating the device’s programmed parameters, lead integrity, battery status, and presence or absence of irregular rhythms.
9. A patient with a leadless pacemaker system undergoes a 40-day remote monitoring period, with the technician evaluating the device’s programmed parameters, lead integrity, battery status, and underlying heart rhythm.
10. A patient with an implantable defibrillator system undergoes a 55-day remote monitoring period, with the technician evaluating the device’s programmed parameters, lead integrity, battery status, and capture functions.