CPT code 93294 is used for remote interrogation evaluation of a pacemaker or implantable cardioverter-defibrillator system.
CPT code 93294 is used for the remote interrogation evaluation of a pacemaker or implantable cardioverter-defibrillator (ICD) system. This code specifically refers to the process where healthcare providers remotely access and analyze data from the patient's pacemaker or ICD to assess its performance and ensure it is functioning correctly. The evaluation includes reviewing the device's settings, battery status, and any recorded arrhythmias or other cardiac events. This remote monitoring is crucial for ongoing patient care, allowing for timely adjustments to the device settings if necessary, without requiring the patient to visit the healthcare facility in person.
For CPT code 93294, which involves the remote interrogation evaluation of a pacemaker or implantable cardioverter-defibrillator (ICD), the following modifiers may be applicable:
1. Modifier 26 - Professional Component: This modifier is used when the service provided is the professional component only, such as the interpretation of the data collected from the remote interrogation.
2. Modifier TC - Technical Component: This modifier is used when the service provided is the technical component only, such as the use of equipment and technical staff to perform the remote interrogation.
3. Modifier 52 - Reduced Services: This modifier may be used if the service was partially reduced or eliminated at the discretion of the healthcare provider.
4. Modifier 76 - Repeat Procedure by Same Physician: This modifier is applicable if the same physician performs the remote interrogation evaluation more than once on the same day.
5. Modifier 77 - Repeat Procedure by Another Physician: This modifier is used if a different physician performs the remote interrogation evaluation on the same day.
6. Modifier 95 - Synchronous Telemedicine Service Rendered via a Real-Time Interactive Audio and Video Telecommunications System: This modifier is used if the remote interrogation evaluation is conducted through telemedicine.
These modifiers help specify the nature of the service provided and ensure accurate billing and reimbursement. It is important to verify payer-specific guidelines as they may have unique requirements for the use of these modifiers.
The CPT code 93294 is reimbursed by Medicare, but the reimbursement is subject to specific conditions and guidelines outlined in the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare, along with the payment rates for each service. However, the actual reimbursement can vary based on geographic location and other factors, as determined by the local Medicare Administrative Contractor (MAC). Each MAC is responsible for processing claims and setting local coverage determinations, which can influence whether and how a particular CPT code like 93294 is reimbursed. Therefore, healthcare providers should consult their specific MAC for detailed information on reimbursement for CPT code 93294.
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