How To Use CPT Code 93295

CPT 93295 describes the evaluation of an implantable defibrillator system by a physician or other qualified healthcare professional from a remote location. 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 93295?

CPT 93295 can be used to describe the evaluation of an implantable defibrillator system by a physician or other qualified healthcare professional from a remote location. This code is used when the provider remotely assesses the device functions, including programmed parameters, leads, battery, capture and sensing function, ventricular tachyarrhythmia therapy, and the patient’s underlying heart rhythm. The provider then evaluates the data and provides written reports to the ordering provider.

2. Official Description

The official description of CPT code 93295 is: ‘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 health care professional.’

3. Procedure

1. The physician or other qualified healthcare professional remotely evaluates the data from an implantable defibrillator system.
2. The provider assesses all device functions, including programmed parameters, leads, battery, capture and sensing function, ventricular tachyarrhythmia therapy, and the patient’s underlying heart rhythm.
3. The provider performs interim analysis, reviews the data, and prepares written reports.
4. The evaluation and analysis are performed over a period of up to 90 days.

4. Qualifying circumstances

CPT 93295 is used for the evaluation of an implantable defibrillator system. This code applies to single, dual, or multiple lead systems. The evaluation is performed remotely by a physician or other qualified healthcare professional. The provider must assess all device functions and provide interim analysis, reviews, and reports. The service can be performed for up to 90 days.

5. When to use CPT code 93295

CPT code 93295 should be used when a physician or other qualified healthcare professional remotely evaluates an implantable defibrillator system. This code is appropriate when the provider performs interim analysis, reviews, and prepares reports for a period of up to 90 days. It is important to note that CPT code 93295 should not be reported in conjunction with CPT code 93289.

6. Documentation requirements

To support a claim for CPT code 93295, the physician or other qualified healthcare professional must document the following information:

• Patient’s diagnosis and the need for evaluation of the implantable defibrillator system
• Specific details of the evaluation, including programmed parameters, leads, battery, capture and sensing function, ventricular tachyarrhythmia therapy, and the patient’s underlying heart rhythm
• Date and duration of the evaluation
• Interim analysis, reviews, and reports provided
• Signature of the physician or other qualified healthcare professional performing the evaluation

7. Billing guidelines

When billing for CPT code 93295, ensure that the evaluation is performed remotely by a physician or other qualified healthcare professional. The service includes interim analysis, reviews, and reports for up to 90 days. It is important to note that CPT code 93295 should not be reported with CPT code 93289. Additionally, for the technical portion of the remote monitoring, CPT code 93296 should be reported.

8. Historical information

CPT code 93295 was added to the Current Procedural Terminology system on January 1, 2009. There have been two updates to the code since its addition, with the most recent change occurring on January 1, 2015.

9. Examples

1. A physician remotely evaluates the data from a single lead implantable defibrillator system over a period of 60 days, performing interim analysis, reviews, and preparing reports.
2. A qualified healthcare professional remotely assesses the functions of a dual lead implantable defibrillator system for a patient with ventricular tachyarrhythmia, providing interim analysis, reviews, and reports over a period of 90 days.
3. A physician remotely evaluates the data from a multiple lead implantable defibrillator system, performing interim analysis, reviews, and preparing reports for a patient with underlying heart rhythm abnormalities.
4. A qualified healthcare professional remotely assesses the functions of a single lead implantable defibrillator system for a patient with a history of tachycardia, providing interim analysis, reviews, and reports over a period of 30 days.
5. A physician remotely evaluates the data from a dual lead implantable defibrillator system, performing interim analysis, reviews, and preparing reports for a patient with a pacemaker and ventricular tachyarrhythmia therapy.
6. A qualified healthcare professional remotely assesses the functions of a multiple lead implantable defibrillator system for a patient with a history of tachyarrhythmia, providing interim analysis, reviews, and reports over a period of 90 days.
7. A physician remotely evaluates the data from a single lead implantable defibrillator system, performing interim analysis, reviews, and preparing reports for a patient with a pacemaker and underlying heart rhythm abnormalities.
8. A qualified healthcare professional remotely assesses the functions of a dual lead implantable defibrillator system for a patient with ventricular tachyarrhythmia, providing interim analysis, reviews, and reports over a period of 60 days.