How To Use CPT Code 93641

CPT 93641 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 93641?

CPT 93641 can be used to describe 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 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 using a monitoring device and may involve pacing the heart and inducing arrhythmias to assess the device’s functionality.

2. Official Description

The official description of CPT code 93641 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 time of initial implantation or replacement; with testing of single or dual chamber pacing cardioverter-defibrillator pulse generator.’

3. Procedure

1. The provider connects the single or dual chamber pacing cardioverter-defibrillator leads to a monitoring device.
2. He records the electrical signals and evaluates the leads’ ability to respond to and regulate an abnormal heart rhythm.
3. The provider may pace the heart and induce arrhythmias to test the device’s ability to sense and terminate abnormal rhythms.
4. He also tests the single or dual chamber pacing cardioverter-defibrillator pulse generator to ensure its proper functioning.
5. The procedure is performed at the time of initial implantation or replacement of the device.

4. Qualifying circumstances

CPT 93641 is performed when a provider needs to evaluate the electrical activity and functionality of single or dual chamber pacing cardioverter-defibrillator leads at the time of initial implantation or replacement. This procedure is typically performed on patients who require a cardioverter-defibrillator device to regulate their heart rhythm. The evaluation helps ensure that the leads and pulse generator are functioning properly and can effectively respond to and regulate abnormal heart rhythms.

5. When to use CPT code 93641

CPT code 93641 should be used when a provider performs 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 code should not be reported separately for subsequent or periodic electronic analysis or reprogramming of the device. Modifier 26 may be used to indicate the professional component of the service.

6. Documentation requirements

To support a claim for CPT 93641, the provider must document the following information:

• Indication for the evaluation and the need for the implantation or replacement of the device
• Details of the electrophysiologic evaluation, including the testing of leads and pulse generator
• Results of the evaluation, including any abnormalities or issues identified
• Date and duration of the procedure
• Signature of the provider performing the evaluation

7. Billing guidelines

When billing for CPT 93641, ensure that the procedure is performed at the time of initial implantation or replacement of the single or dual chamber pacing cardioverter-defibrillator leads. This code should not be reported separately for subsequent or periodic electronic analysis or reprogramming of the device. Modifier 26 may be used to indicate the professional component of the service. It is important to review payer-specific guidelines and documentation requirements to ensure accurate billing and reimbursement.

8. Historical information

CPT 93641 was added to the Current Procedural Terminology system on January 1, 1994. There have been no updates to the code since its addition.

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 for a patient with a history of ventricular arrhythmias.
2. A cardiac electrophysiologist conducts an electrophysiologic evaluation of dual chamber pacing cardioverter-defibrillator leads, including defibrillation threshold evaluation, during a replacement procedure for a patient with a malfunctioning device.
3. An electrophysiologist tests the electrical activity and functionality of single chamber pacing cardioverter-defibrillator leads, including defibrillation threshold evaluation, at the time of initial implantation for a patient with a high risk of sudden cardiac arrest.
4. A cardiac surgeon performs an electrophysiologic evaluation of dual chamber pacing cardioverter-defibrillator leads, including defibrillation threshold evaluation, during a replacement procedure for a patient with a history of atrial fibrillation.
5. An interventional cardiologist evaluates the electrical signals and defibrillation threshold of single chamber pacing cardioverter-defibrillator leads at the time of initial implantation for a patient with a weakened heart muscle.
6. A cardiac electrophysiologist tests the functionality of dual chamber pacing cardioverter-defibrillator leads, including defibrillation threshold evaluation, during a replacement procedure for a patient with recurrent ventricular tachycardia.