Cardiology Coding Alert

Question: Which code is appropriate for evaluating data stored in a wearable cardioverter-defibrillator vest?

New Mexico Subscriber

Answer: The most appropriate code for this service is 93292 (Interrogation device evaluation [in person] with physician analysis, review and report, includes connection, recording and disconnection per patient encounter; wearable defibrillator system).

This code was part of the 2009 cardiac device coding revolution that brought numerous new codes. Before 2009, you would have reported the service with nowdeleted code 93741 (Electronic analysis of pacing cardioverter-defibrillator [includes interrogation, evaluation of pulse generator status, evaluation of programmable parameters at rest and during activity where applicable, using electrocardiographic recording and interpretation of recordings at rest and during exercise, analysis of event markers and device response]; single chamber or wearable cardioverter-defibrillator system, without reprogramming).

Code 93292 is specific to wearable devices, such as the vest you mention. The wearable cardioverter-defibrillator does the same work as an implantable one, but physicians may choose the vest when an invasive implant isn't right for a patient. The patient wears a sort of vest with sensors that measure heartbeat. The vest also has a small defibrillator to shock the heart when the sensors detect a dangerously irregular heartbeat.

According to a 93292 example in CPT Changes 2009, elements reviewed may include, but are not limited to, the following:

• presenting electrograms

• stored episodes

• alerts

• battery

• leads

• capture and sensing function

• heart rhythm.

Coding clue: CPT guidelines instruct you not to report eval code 93292 on the same date as set-up code 93745 (Initial set-up and programming by a physician of wearable cardioverter-defibrillator includes initial  programming of system, establishing baseline electronic ECG, transmission of data to data repository, patient instruction in wearing system and patient reporting of problems or events).

-- You Be the Coder and Reader Questions prepared with the assistance of Jim Collins, CCC, CPC, ACS-CA, CHCC, president of www.CardiologyCoder.Com.