Cardiology Coding Alert

Question: Would you give me some direction on how to bill for interrogation, analysis and reprogramming of biventricular devices? We've been told to use 93799 (Unlisted cardiovascular service or procedure) but aren't sure if this is correct. Massachusetts Subscriber Answer: Interrogation, analysis and reprogramming are services that patients with biventricular devices must receive, but there is no clear way to bill for them. For analysis of single- and dual-chamber pacemakers and cardioverter-defibrillators, you would report 93741-93744, but CPT does not specify the correct way to report biventricular device analysis.

Additionally, CPT does not indicate how you should report the analysis of a device with leads implanted only in both ventricles (i.e., one lead in the left ventricle and one lead in the right ventricle, but no lead in the right atrium).

Until the AMA addresses the issue of biventricular device analysis, you should consult your insurance carrier for advice on how to handle this. At least one Medicare carrier Trailblazer advises billing 93799 for monitoring InSync Tripolar Cardiac Pacemakers. Note: Cardiology consultants have requested that the AMA provide specific instructions on how to report biventricular analysis services. Cardiology Coding Alert will publish the AMA's directions as soon as the response is available.