How To Use CPT Code 93285

CPT 93285 describes the programming device evaluation for subcutaneous cardiac rhythm monitor systems. 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 93285?

CPT 93285 is used to describe the programming device evaluation for subcutaneous cardiac rhythm monitor systems. This code represents a face-to-face evaluation performed by a physician or other qualified healthcare professional. The evaluation involves iterative adjustment of the implantable device to test its function and select optimal permanent programmed values. The provider also analyzes, reviews, and prepares a report based on the results of the evaluation.

2. Official Description

The official description of CPT code 93285 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; subcutaneous cardiac rhythm monitor system.’

3. Procedure

1. The physician or qualified healthcare professional performs a face-to-face evaluation of the subcutaneous cardiac rhythm monitor system.
2. They connect the patient to an electrocardiogram (ECG) monitor, establishing a communication link between the monitor system and the programmer.
3. The provider analyzes and reviews various parameters of the data stored in the system, comparing it to current readings.
4. Based on the analysis, they may make iterative adjustments to the settings of the implantable device and retest its function.
5. The provider determines the optimal permanent programmed values for the device to optimize its performance.
6. Finally, they prepare a report summarizing the evaluation, adjustments made, and the results.

4. Qualifying circumstances

CPT 93285 is used for the programming device evaluation of subcutaneous cardiac rhythm monitor systems. The evaluation is performed by a physician or other qualified healthcare professional. The patient must have an already implanted subcutaneous cardiac rhythm monitor system that requires evaluation and adjustment. The provider must analyze, review, and prepare a report based on the evaluation. It is important to note that CPT 93285 should not be reported in conjunction with codes 33285, 93279-93284, 93291, or 0650T.

5. When to use CPT code 93285

CPT code 93285 should be used when a physician or other qualified healthcare professional performs a programming device evaluation for a subcutaneous cardiac rhythm monitor system. This code represents the in-person evaluation and adjustment of the implantable device to test its function and select optimal permanent programmed values. It is important to ensure that the evaluation is face-to-face and that the provider performs the necessary analysis, review, and report preparation.

6. Documentation requirements

To support a claim for CPT 93285, the provider must document the following information:

• Patient’s diagnosis and the need for the programming device evaluation
• Specific details of the evaluation, including the parameters analyzed and adjusted
• Date and duration of the evaluation
• Results of the evaluation and any changes made to the device’s programming
• Preparation of a report summarizing the evaluation and its findings
• Signature of the physician or qualified healthcare professional performing the evaluation

7. Billing guidelines

When billing for CPT 93285, ensure that the evaluation is performed by a physician or other qualified healthcare professional. The evaluation should be face-to-face and involve iterative adjustment of the implantable device. It is important to note that CPT 93285 should not be reported in conjunction with codes 33285, 93279-93284, 93291, or 0650T. Properly identifying and reporting the type of device being evaluated is also crucial for accurate billing.

8. Historical information

CPT 93285 was added to the Current Procedural Terminology system on January 1, 2009. Since its addition, there have been several historical changes to the code, including updates to the description and the addition of notes regarding reporting with other codes.

9. Examples

1. A physician performing a programming device evaluation for a subcutaneous cardiac rhythm monitor system, adjusting the device’s parameters and preparing a report based on the evaluation.
2. A qualified healthcare professional analyzing and reviewing the data stored in a subcutaneous cardiac rhythm monitor system, making iterative adjustments to the device’s settings, and selecting optimal permanent programmed values.
3. A physician performing a face-to-face evaluation of an already implanted subcutaneous cardiac rhythm monitor system, testing its function and making necessary adjustments to optimize its performance.
4. A qualified healthcare professional connecting a patient to an electrocardiogram (ECG) monitor, establishing communication with a subcutaneous cardiac rhythm monitor system, and analyzing the data stored in the system to determine the optimal programming values.