# Pacemaker interrogation INPATIENT - documentation?



## ChrisZim (Jul 29, 2016)

One of my cardio's wants to bill for a pacemaker interrogation (93288) done when he saw a patient (inpatient) at the hospital.

He is wanting to bill a 93222, 93288-26.  My issue is that the only documentation of the interrogation is in his patient encounter note (what he is using to support the 93222).  There is no separate report/readings record of the PCM interrogation.  His note does list the ohms, etc. of the leads and that no changes were made.  It was my understanding that to bill a 93288, a separate report needs documented (much the way he can't bill an EKG interpretation and report - 93010 - just by mentioning what the tracing showed in his regular progress note).  But I can't actually find anything documenting that it is required.

Any thoughts?  TIA


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## danskangel313 (Aug 8, 2016)

ChrisZim said:


> One of my cardio's wants to bill for a pacemaker interrogation (93288) done when he saw a patient (inpatient) at the hospital.
> 
> He is wanting to bill a 93222, 93288-26.  My issue is that the only documentation of the interrogation is in his patient encounter note (what he is using to support the 93222).  There is no separate report/readings record of the PCM interrogation.  His note does list the ohms, etc. of the leads and that no changes were made.  It was my understanding that to bill a 93288, a separate report needs documented (much the way he can't bill an EKG interpretation and report - 93010 - just by mentioning what the tracing showed in his regular progress note).  But I can't actually find anything documenting that it is required.
> 
> Any thoughts?  TIA



Are you certain the code is 93222? I show that as a deleted code. 93288 shouldn't be billed with a 26 as the code is for both the professional and technical components. 

Here's how the description reads:
"Clinical Responsibility
In this procedure, the provider does a face to face, or in person, evaluation of an implantable cardiac pacemaker. Using an office, hospital, or emergency room instrument, the provider or other qualified healthcare professional retrieves the stored and measured information about the one or more leads when present, one or more sensors when present, battery and the implanted pulse generator function, as well as data collected about the patient's heart rhythm and heart rate.
The provider then evaluates the information he retrieves to determine the current programming of the device and also to evaluate certain aspects of the device function. Report this code if the provider performs a device interrogation, which includes connection, recording, and disconnection of a single, dual, or multiple lead pacemaker system along with *analysis, review, and report by a provider*."

And just as you mentioned, I agree that an interpretation, analysis and report would need to be completed, not just a few pieces of information stuck into an encounter note.


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## espressoguy (Aug 9, 2016)

I had a similar situation a couple of weeks ago. One of my cardiologists did a device interrogation in the hospital and there was no separate report. The difference between your situation was that my guy didn't bill for it. I did query him to see if the separate report was available and he indicated that it was not which was why he [correctly] didn't bill for it.

Also, danskangel313, it is correct to add a 26 to the physician's interpretation when the device interrogation is done in the hospital.


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## danskangel313 (Aug 9, 2016)

espressoguy said:


> I had a similar situation a couple of weeks ago. One of my cardiologists did a device interrogation in the hospital and there was no separate report. The difference between your situation was that my guy didn't bill for it. I did query him to see if the separate report was available and he indicated that it was not which was why he [correctly] didn't bill for it.
> 
> Also, danskangel313, it is correct to add a 26 to the physician's interpretation when the device interrogation is done in the hospital.



Gotcha! Thanks for the heads up.


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## ChrisZim (Aug 10, 2016)

Thank you both for your replies!  I did have a typo in my original note - the codes he wants to bill are 99222 (init inpt enc) & the pacer interrogation/report code 93288-26.  I appreciate the add'l opinions - I haven't been able to lay my hands on anything to back up my opinion that it has to be better documented, but I will go back to the provider and see if the EKG analogy helps him.  Wish me luck!


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