How To Use CPT Code 93640

CPT 93640 describes the electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads, including defibrillation threshold evaluation, at the time of initial implantation or replacement. 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 93640?

CPT 93640 can be used to describe the electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads, including the evaluation of sensing and pacing for arrhythmia termination. This code is used when the provider tests the electrical activity of the leads and their ability to respond to and regulate an abnormal heart rhythm. The evaluation is performed at the time of initial implantation or replacement of the device.

2. Official Description

The official description of CPT code 93640 is: ‘Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads, including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination) at the time of initial implantation or replacement.’

3. Procedure

1. The provider connects the cardioverter-defibrillator leads to a monitoring device.
2. He records the electrical signals and evaluates the sensing and pacing capabilities of the leads.
3. The provider induces arrhythmias to test the device’s ability to sense and terminate abnormal rhythms.
4. He evaluates the defibrillation threshold, which is the point at which the device initiates defibrillation to restore a normal heart rhythm.
5. The procedure is performed at the time of initial implantation or replacement of the cardioverter-defibrillator leads.

4. Qualifying circumstances

CPT 93640 is performed when a provider needs to evaluate the electrical activity and functionality of single or dual chamber pacing cardioverter-defibrillator leads. This procedure is typically done at the time of initial implantation or replacement of the leads. It is important to note that this code should not be reported separately for the induction of arrhythmia or internal cardioversion, as these services are included in CPT 93640.

5. When to use CPT code 93640

CPT code 93640 should be used when a provider performs the electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads at the time of initial implantation or replacement. It is important to ensure that the evaluation includes the assessment of defibrillation threshold, sensing, and pacing for arrhythmia termination.

6. Documentation requirements

To support a claim for CPT 93640, the provider must document the following information:

• Indication for the evaluation of the cardioverter-defibrillator leads
• Date and time of the procedure
• Specific details of the evaluation, including the induction of arrhythmias and assessment of sensing and pacing capabilities
• Results of the evaluation, including the defibrillation threshold
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 93640, ensure that the procedure involves the evaluation of single or dual chamber pacing cardioverter-defibrillator leads at the time of initial implantation or replacement. It is important to note that this code should not be reported separately for the induction of arrhythmia or internal cardioversion. Modifier 26 should be used for the professional component of the service.

8. Historical information

CPT 93640 was added to the Current Procedural Terminology system on January 1, 1990. The code underwent a change on January 1, 2010, with an updated description.

9. Examples

1. A cardiologist performs an electrophysiologic evaluation of single chamber pacing cardioverter-defibrillator leads, including defibrillation threshold evaluation, at the time of initial implantation.
2. A cardiac electrophysiologist evaluates the sensing and pacing capabilities of dual chamber pacing cardioverter-defibrillator leads, including defibrillation threshold evaluation, during a replacement procedure.
3. A cardiac surgeon performs an electrophysiologic evaluation of single chamber pacing cardioverter-defibrillator leads, including defibrillation threshold evaluation and induction of arrhythmia, at the time of initial implantation.
4. An electrophysiologist evaluates the sensing and pacing capabilities of dual chamber pacing cardioverter-defibrillator leads, including defibrillation threshold evaluation and induction of arrhythmia, during a replacement procedure.
5. A cardiac electrophysiologist performs an electrophysiologic evaluation of single chamber pacing cardioverter-defibrillator leads, including defibrillation threshold evaluation, induction of arrhythmia, and evaluation of sensing and pacing, at the time of initial implantation.
6. A cardiologist evaluates the sensing and pacing capabilities of dual chamber pacing cardioverter-defibrillator leads, including defibrillation threshold evaluation, induction of arrhythmia, and evaluation of sensing and pacing, during a replacement procedure.