Cardiology Coding Alert

Question: Can the facility charge for 93286 (Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review and report by a physician or other qualified health care professional; single, dual, or multiple lead pacemaker system, or leadless pacemaker system) or 93287 (… single, dual, or multiple lead implantable defibrillator system) when the cardiologist performs these services with the implant of the pacemaker or implantable cardioverter-defibrillators (ICDs) device procedure?

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Answer: No. These codes are bundled with the pacemaker insertion codes because the monitoring, interrogation, and programming are all incidental to the procedure. However, the National Correct Coding Initiative (NCCI) does allow these to be unbundled with a modifier in the unusual case that the documentation would support that these were unrelated to the procedure itself.

Coding tips: Report 93286 and 93287 only once before and once after a surgery, procedure, or test, when your cardiologist performs the device evaluation and programming before and after the surgery, procedure, or test, according to CPT^®.

Report 93286 and 93287 in conjunction with 0696T (Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of follow-up interrogation or programming device evaluation) when body surface-activation mapping to optimize electrical synchrony is also performed.