Wiki Pacemaker/AICD interrogations

[Mountain Heart]

Does anyone have information (sources) on pacemaker/AICD interrogations done in an in-office setting, but performed by a pacemaker representative rather than a clinic provider? Looking for CMS documentation on billing (our physician does the interpretations). Thx

 

[mshay134]

According to CPT 2012 Codes 93279 -93292 is in regards to physician analysis, not to who actually performed the programming and/or adustment.

 

[s9uccess]

Does anyone have information (sources) on pacemaker/AICD interrogations done in an in-office setting, but performed by a pacemaker representative rather than a clinic provider? Looking for CMS documentation on billing (our physician does the interpretations). Thx

Here is the CMS link:
https://www.cms.gov/transmittals/downloads/R1931CP.pdf

When the pacemaker representative performs the technical portion of the evaluation you cannot bill for those services unless the criteria for antimarkup payment is met. I would read the entire thing but specifically 10.1.12 and 30.3.7. If this is not met then a 26 modifier should be added only if the provider completed the professional portion of the service.