How To Use CPT Code 93281

CPT 93281 describes the evaluation and adjustment of an implantable multiple lead pacemaker system by a physician or other qualified healthcare professional. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 93281?

CPT 93281 can be used to describe the evaluation and adjustment of an already implanted multiple lead pacemaker system. This code represents both the professional and technical components of the service, where the provider analyzes and reviews the parameters of the pacemaker data and determines the optimal programming values for the device.

2. Official Description

The official description of CPT code 93281 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; multiple lead pacemaker system.’

3. Procedure

1. The provider performs a face-to-face evaluation of the patient with an implanted multiple lead pacemaker system.
2. The provider connects the patient to an electrocardiogram (ECG) monitor, establishing a communication link between the pacemaker and the programmer.
3. The provider analyzes and reviews the parameters of the stored pacemaker data, comparing it to current readings.
4. Based on the analysis, the provider determines whether to adjust the programming of the device to optimize its performance.
5. The provider iteratively adjusts the parameters of the pacemaker system to test its function and select the optimal permanent programmed values.
6. The provider completes an analysis, review, and report of the evaluation and adjustment process.

4. Qualifying circumstances

CPT 93281 is applicable to patients with an already implanted multiple lead pacemaker system. The evaluation and adjustment of the device must be performed by a physician or other qualified healthcare professional. The provider must have the necessary education, training, licensure, and facility privileging to perform the service. It is important to note that CPT 93281 should not be reported in conjunction with CPT codes 93286 and 93288.

5. When to use CPT code 93281

CPT code 93281 should be used when a provider performs a face-to-face evaluation and iterative adjustment of an implantable multiple lead pacemaker system to test its function and select optimal permanent programmed values. This code represents both the professional and technical components of the service. It is important to properly identify and report the type of device being evaluated when using CPT code 93281.

6. Documentation requirements

To support a claim for CPT 93281, the provider must document the following information:

• Patient’s medical history and indication for the evaluation and adjustment of the pacemaker system
• Specific parameters analyzed and adjusted during the procedure
• Date and duration of the evaluation and adjustment session
• Analysis, review, and report of the evaluation and adjustment process
• Signature of the physician or other qualified healthcare professional performing the service

7. Billing guidelines

When billing for CPT 93281, ensure that the provider performing the service is a physician or other qualified healthcare professional. It is important to follow the appropriate coding guidelines and not report CPT 93281 in conjunction with CPT codes 93286 and 93288. Additionally, consider the use of modifiers when necessary to accurately represent the service provided.

8. Historical information

CPT 93281 was added to the Current Procedural Terminology system on January 1, 2009. There have been historical changes to the code, including updates to the description and the addition of notes.

9. Examples

1. A physician performing an evaluation and adjustment of an implanted multiple lead pacemaker system to optimize its function and programming values.
2. A qualified healthcare professional analyzing and reviewing the parameters of a patient’s pacemaker data and making iterative adjustments to improve its performance.
3. A provider connecting a patient with an implanted multiple lead pacemaker system to a programmer and evaluating its function through analysis and adjustment.
4. A physician reviewing the stored pacemaker data of a patient and making programming changes to optimize the performance of the multiple lead pacemaker system.
5. A qualified healthcare professional performing an in-person evaluation and adjustment of an implanted multiple lead pacemaker system to select the optimal permanent programmed values.
6. A provider analyzing and reviewing the pacemaker data of a patient with a multiple lead pacemaker system and making iterative adjustments to ensure its optimal function.
7. A physician evaluating the function of an implanted multiple lead pacemaker system and making programming changes to improve its performance based on the analysis.
8. A qualified healthcare professional adjusting the parameters of a patient’s multiple lead pacemaker system to optimize its function and select the optimal permanent programmed values.
9. A provider performing an evaluation and adjustment of an implanted multiple lead pacemaker system to test its function and make programming changes for optimal performance.