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In office pacemaker/ICD programming by reps

  1. Question In office pacemaker/ICD programming by reps
    Medical Coding Books
    We are having a rep from the pacemaker/ICD companies do our interrogation/programming on our pts since Jan 1st and we have one of our employees that brings the pt to the room, hooks them up and is present while the interrogation/promamming is taking place, my question is whether or not we need to use modifier 26 on the codes. We always have a doctor in the office when this is being done and at times the pt will have a f/u visit as well after their device is checked. The 2 different reps are from 2 separate companies and one rep is telling us to use modifier 26, and the other one tells us we don't need it. Can anyone tell me which is correct?

  2. #2
    Duluth, Minnesota
    well, I can tell you that for us:
    if the tech is present - we do put a .26 on the procedure (for our physician billing) . and a .25 modifier on the E/M visit...
    Donna, CPC, CPC-H

  3. #3
    With the new 2009 codes you do not need a modifier on them especially if the doc is present. Also for an office visit add -25 on the office, but be careful on these, if you bill to many office with the device checks you will raise a flag. If the doc is seeing the patient for the device check review after the check is done and nothing else is being examined, you shouldn't bill for an office visit with the device check

  4. Default Pacemaker/ICD Checks Done By Rep in Office Setting
    Could you direct me to the source for your comment on not needing the Modifier 26 when a rep from a company is performing the testing in the physician's office, please. There seems to be major controversy regarding this issue. If you do not own the equipment even though the physician is present in the suite, I do not see how you can bill for full service. Thanks!

  5. #5
    I have materials from Medtronic and also in the CPT book when reading the summary of the code, for code 93288 (in person) with physician analysis..... plus we do have equipment that stays here, I don't know if we're leasing or own it, (I should have mentioned that before) Our rep comes back on Monday I'll talk to them then

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