Programming and Interrogation

NESmith

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I am really new at coding for an EP specialist and I have a couple of question that was told to the provider by an outside source. Is it appropriate to bill for the professional component for programming (93279-93284) or for interrogation and analysis (93288-93289) the day after an ICD or pacer is inserted at the hospital. And what is a transseptal puncture during an EP study. Any help you can give would be greatly appreciated. Thanks
 

Jess1125

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I can't speak for the 2nd question because I don't code an EP.

I will say for the pacemaker checks, though, you can bill the professional components of these codes when checking the following day as pacemaker/device checks aren't included in the global period.

Jessica CPC, CCC
 

Misty Dawn

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You should use the peri/post procdural codes.

93286 Peri-procedural device evaluation and programming of device system parameters before or after a surgery, procedure, or test with physician analysis, review and report; single, dual, or multiple lead pacemaker system
93287 Peri-procedural device evaluation and programming of device system parameters before or after a surgery, procedure, or test with physician analysis, review and report; single, dual, or multiple lead implantable cardioverter-defibrillator

For examples and answers to peri/post codes please see doc: http://www.bostonscientific.com/cardiac-rhythm-resources/assets/downloads/reimbursement/2010/CRM5-1754-FAQ-Device-Monitoring-Codes.pdf
 

NESmith

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Thank You so much for your reply, but i need to ask another question. Do you still use the peri-procedural codes at the time of implant (Pacemaker/ICD) or would you use programming? I am being told so many different things. Help
 

OliviaPrice

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We use the programming codes the day following the implant. It is my understanding that the peri-procedural codes are to be used when the device has already been implanted and the device has to be adjusted pre/post a procedure to accomodate that procedure.
 

deeva456

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I am really new at coding for an EP specialist and I have a couple of question that was told to the provider by an outside source. Is it appropriate to bill for the professional component for programming (93279-93284) or for interrogation and analysis (93288-93289) the day after an ICD or pacer is inserted at the hospital. And what is a transseptal puncture during an EP study. Any help you can give would be greatly appreciated. Thanks[/quote]

To answer your second question.....transseptal puncture is done during an EP Study and/or ablation for atrial fibrillation. The Dr enters the left atrium/ventricle through the septum for pacing, recording and/or ablation; however there isnt a separate CPT code to describe the transseptal puncture.

93527 is combined rt & left heart cath w/transseptal puncture but medical necessity has to be documented to warrent doing a rt heart cath @ the time of the EP Study or ablation. In most cases I have reviewed, a rt heart cath is rarely done. I would be happy to email you some reading material about transseptal puncture. Here is my email address:
valenzd1@sutterhealth.org

I hope this has made sense.

Dolores CCC, CPC
 
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