# Interrogation vs evaluation of ICD



## Shrina (Jul 20, 2012)

Can someone PLEASE explain to me the difference between interrogation and evaluation of and ICD?  It seems pretty clear cut for pacemakers but not for ICDs.


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## hewitt (Jul 20, 2012)

From what I understand, the AMA's CPT Assistant focuses on the unit itself for evaluation, but goes further by determining how the unit is affecting the organ for interrogation. So, unit only for evaluation, and unit plus organ for interrogation. Hope this helps. 

Please see below for example of interrogation: "Clinical Vignette: 93741 (93295 for 2012) A 66-year old male with coronary artery disease, ischemic cardiomyopathy, cardiac arrest, and sinus node dysfunction underwent dual chamber pacing cardioverter-defibrillator insertion 1 year ago. In follow-up analysis, the patient is directed to place the antenna of the device's monitor-transmitter over the implanted device and initiate transfer of device data. The device is interrogated to determine the number of supraventricular, nonsustained and sustained ventricular tachyarrhythmia events; the pacing and shocking therapy delivered with the associated shock impedance; and characteristics of the electrograms documenting episodes of tachycardia treated with either antitachycardia pacing or an internal shock. The sensing, pacing, and rate response parameters are recorded, along with the impedance of the lead. Capacitor charge time, battery voltage, and impedance are measured. Following completion of the data transfer to the home monitor, the monitor-transmitter transmits the interrogated data to an external secure server. Using a secure authorization code, the physician accesses the server to obtain the transmitted data and to complete the analysis, which includes: 

·Evaluation of the battery voltage and capacitor status to confirm adequate battery reserve 

·Evaluation of the patient's rhythm at the time of the interrogation to determine appropriate sensing and/or pacing characteristics 

·Evaluation of recently measured pacing and high voltage lead impedances 

Stored electrogram and counter data documenting treated episodes of ventricular tachycardia or ventricular fibrillations are reviewed to make certain that the device is functioning properly. The results of the interrogation are reviewed with the patient and family and documented in the patient's history, and a report is generated and sent to the referring physician.


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