Pacemaker/AICD interrogations

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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

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

s9uccess

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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.
 
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