CPT® Code 0826T

Official Description

Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional, leadless pacemaker system in single-cardiac chamber

Common Language Description

The CPT® Code 0826T refers to the process of programming and evaluating an implantable leadless pacemaker system within a single cardiac chamber. This procedure is conducted in person and involves a comprehensive assessment of the device's functionality. During the evaluation, the healthcare professional performs an interrogation of the device to ensure it is operating correctly and to identify any potential issues that may affect its performance. The evaluation includes iterative adjustments to the device settings, allowing for the selection of optimal permanent programmed values tailored to the patient's specific needs. The physician or qualified healthcare professional conducts a thorough analysis and review of the device's data, which includes monitoring the patient's cardiac rhythm through an EKG. This process is crucial for ensuring that the pacemaker is effectively managing the patient's heart rhythm and addressing any symptoms that may arise. The evaluation also involves a detailed review of stored data to identify any arrhythmias, out-of-range parameters, or alerts that may indicate a malfunction. By adjusting the pacing parameters and thresholds, the healthcare provider aims to enhance the device's performance and improve patient outcomes.

1. Indications

The procedure associated with CPT® Code 0826T is indicated for patients who have an implantable leadless pacemaker system in a single cardiac chamber. The specific indications for performing this device evaluation include:

Suspected Device Malfunction - When there are concerns regarding the proper functioning of the leadless pacemaker, necessitating a thorough evaluation.
Patient Symptoms - If the patient exhibits symptoms that suggest the need for more effective pacing parameters or adjustments to the device settings.
Monitoring Arrhythmias - To assess any recorded arrhythmic events and determine if they were appropriately identified by the pacemaker.

2. Procedure

The procedure for CPT® Code 0826T involves several critical steps to ensure the effective evaluation and programming of the leadless pacemaker:

Step 1: Patient Connection - The patient is connected to an electrocardiogram (EKG) to continuously monitor and record the cardiac rhythm during the evaluation process.
Step 2: Data Review - The healthcare professional reviews the stored data from the device, assessing it for any arrhythmia events, out-of-range parameters, or alerts that may indicate issues with the device's performance.
Step 3: Arrhythmic Assessment - Any arrhythmic episodes recorded by the device are evaluated to determine their nature and whether they were detected by the pacemaker.
Step 4: Rhythm Recording - Atrial pacing from the device is temporarily suspended to record the underlying cardiac rhythm, allowing for a clearer assessment of the heart's natural activity.
Step 5: Capture Threshold Evaluation - The pacing capture thresholds are determined by adjusting the pacing voltage while maintaining a fixed pulse width, or vice versa, to ensure effective pacing.
Step 6: Function Evaluation - The capture function of the device is evaluated to confirm that it is effectively stimulating the heart as intended.
Step 7: Historical Comparison - Current interrogation results are compared with historical data and trends, including battery function, voltage, pacing capture threshold, and impedance, to identify any changes or concerns.
Step 8: Parameter Adjustment - Based on the findings, programmed parameters and sensing thresholds are adjusted as necessary to optimize the device's function for the patient.

3. Post-Procedure

After the completion of the device evaluation and programming, the patient may be monitored for a short period to ensure that the adjustments made to the pacemaker are effective and that there are no immediate complications. The healthcare provider will review the results of the evaluation with the patient, discussing any changes made to the device settings and the expected outcomes. Follow-up appointments may be scheduled to continue monitoring the device's performance and the patient's symptoms, ensuring ongoing optimal management of their cardiac condition.

Short Descr	PRGRMG EVL LDLS PM 1CHMBR IP
Medium Descr	PRGRMG DEV EVAL LDLS PM SINGLE CAR CHAMBER IP
Long Descr	Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional, leadless pacemaker system in single-cardiac chamber
Status Code	Carriers Price the Code
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	1 - Diagnostic Tests for Radiology Services
Multiple Procedures (51)	6 - Special payment adjustment rules on the technical component (TC) of multiple diagnostic cardiovascular services apply...
Bilateral Surgery (50)	0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62)	0 - Co-surgeons not permitted for this procedure.
Team Surgery (66)	0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	STV-Packaged Codes
Berenson-Eggers TOS (BETOS)	none
MUE	1

26	Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number.
GC	This service has been performed in part by a resident under the direction of a teaching physician