How To Use CPT Code 93644

CPT 93644 describes the electrophysiologic evaluation of a subcutaneous implantable defibrillator, including the assessment of defibrillation threshold, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parameters. 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 93644?

CPT 93644 can be used to describe the electrophysiologic evaluation of a subcutaneous implantable defibrillator. This procedure involves assessing the defibrillation threshold, inducing arrhythmia, evaluating sensing for arrhythmia termination, and programming or reprogramming the device’s sensing or therapeutic parameters. It is performed to ensure the proper functioning and effectiveness of the subcutaneous defibrillator system.

2. Official Description

The official description of CPT code 93644 is: ‘Electrophysiologic evaluation of subcutaneous implantable defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parameters).’

3. Procedure

1. The provider begins by preparing the patient and administering anesthesia.
2. A small incision is made in the groin, and a catheter is inserted into the femoral artery.
3. The provider guides the catheter up to the heart using a guide wire.
4. Electrical signals are transmitted to the heart through the leads of the subcutaneous defibrillator system to determine the pacing threshold.
5. The provider induces an arrhythmia and observes the sensing capabilities of the defibrillator.
6. The threshold necessary for arrhythmia termination is determined by delivering an electric shock to the heart using the leads.
7. The provider may program or reprogram the device’s function parameters as needed.

4. Qualifying circumstances

CPT 93644 is performed on patients who have a subcutaneous implantable defibrillator system and require an electrophysiologic evaluation. This procedure is typically done to assess the device’s functionality, determine the appropriate settings for arrhythmia termination, and ensure optimal sensing capabilities. It is important to note that CPT 93644 should not be reported in conjunction with CPT 33270 at the time of subcutaneous implantable defibrillator device insertion.

5. When to use CPT code 93644

CPT code 93644 should be used when performing an electrophysiologic evaluation of a subcutaneous implantable defibrillator. This code is appropriate when the provider assesses the defibrillation threshold, induces arrhythmia, evaluates sensing for arrhythmia termination, and programs or reprograms the device’s sensing or therapeutic parameters. It is important to ensure that the evaluation is specific to the subcutaneous implantable defibrillator system.

6. Documentation requirements

To support a claim for CPT 93644, the provider must document the following information:

• Patient’s diagnosis and indication for the electrophysiologic evaluation
• Details of the procedure, including the specific steps performed
• Results of the evaluation, including the defibrillation threshold, arrhythmia induction, and sensing evaluation
• Any programming or reprogramming of the device’s parameters
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 93644, ensure that the procedure meets the requirements outlined in the official description. It is important to note that CPT 93644 should not be reported in conjunction with CPT 33270 at the time of subcutaneous implantable defibrillator device insertion. Additionally, for subsequent or periodic electrophysiologic evaluation of a subcutaneous implantable defibrillator device, CPT codes 93260 and 93261 should be used. If the evaluation involves a subcutaneous implantable defibrillator system with a substernal electrode, use CPT code 0577T.

8. Historical information

CPT 93644 was added to the Current Procedural Terminology system on January 1, 2015. There have been no updates to the code since its addition.

9. Examples

1. A provider performs an electrophysiologic evaluation of a subcutaneous implantable defibrillator, assessing the defibrillation threshold, inducing arrhythmia, evaluating sensing for arrhythmia termination, and programming the device’s parameters.
2. During an electrophysiologic evaluation, the provider determines the appropriate settings for arrhythmia termination and reprograms the sensing parameters of a subcutaneous implantable defibrillator.
3. A patient with a subcutaneous implantable defibrillator undergoes an electrophysiologic evaluation to assess the device’s functionality and ensure optimal sensing capabilities.
4. The provider induces an arrhythmia and evaluates the sensing capabilities of a subcutaneous implantable defibrillator during an electrophysiologic evaluation.
5. During an electrophysiologic evaluation, the provider determines the defibrillation threshold and programs the therapeutic parameters of a subcutaneous implantable defibrillator.
6. A subcutaneous implantable defibrillator undergoes an electrophysiologic evaluation, including the assessment of defibrillation threshold, induction of arrhythmia, and evaluation of sensing for arrhythmia termination.
7. The provider performs an electrophysiologic evaluation of a subcutaneous implantable defibrillator, programming the device’s sensing and therapeutic parameters based on the results.