Cardiac Device Billing CPT Codes

Cardiac Device Monitoring Services

CPT 93294, 93295, 93296 -  Reported no more than once every 90 days. Do not report if the monitoring period is less than 30 days.

CPT 93297, 93299, G2066 -  Reported no more than once every 30 days. Do not report if the monitoring period is less than 10 days.

CPT 93264 - Reported no more than once every 30 days. Do not report if the monitoring period is less than 30 days.

May not be reported with in-person interrogation device evaluations and programming on the same date by the same individual.

For subcutaneous cardiac rhythm monitors, may not be reported with programming device evaluations for pacemakers and ICDs.

It may be reported with programming device evaluations during the remote interrogation device evaluation period.

May not be reported with in-person interrogation and device evaluations on the same date by the same individual. 

Report only remote services when an in-person interrogation device evaluation is performed during a period of remote interrogation device evaluation. 

However, a service center may report the technical code for remote interrogation (93296) during a period in which a physician or other qualified health professional performs an in-person interrogation device evaluation.

Peri-Procedural Device Evaluation Reported once before and once after surgery, procedure or test, when device evaluation and programming is performed before and after surgery, procedure or test.

If one provider performs both the pre-and post-evaluation and programming service, the appropriate code (93286 for pacemakers or 93287 for implantable defibrillators) would be reported two times. 

If one provider performs the pre-surgical service and a separate provider performs the post-surgical service, each provider reports either code only one time.

Programming or Device ERI/EOL

Z45.01 Encounter for adjustment and management of cardiac pacemaker or cardiac resynchronization therapy pacemaker (CRT-P)

Z45.02 Encounter for adjustment and management of automatic implantable cardiac defibrillator, automatic implantable cardiac defibrillator with synchronous cardiac pacemaker or cardiac resynchronization therapy defibrillator (CRT-D)

Z45.09 Encounter for adjustment and management of other cardiac device [used for ICMs] 

Interrogations

Z95.0 Presence of cardiac pacemaker or cardiac resynchronization therapy (CRT-P) pacemaker

Z95.810 Presence of automatic (implantable) cardiac defibrillator, automatic (implantable) cardiac defibrillator with synchronous cardiac pacemaker, cardiac resynchronization therapy defibrillator (CRT-D) or cardioverter-defibrillator (ICD)

Z95.818 Presence of other cardiac implants and grafts [for ICMs]

Note

Physicians should not report codes 93264 and G2066 together because 93264 includes the professional and technical components in the payment rate. 

However, G2066 may be billable by Outpatient Hospitals for the technical data acquisitions of PA pressure sensor remote monitoring if the requirements of the code are met.  

Check RPM Guidelines