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Official Description

Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; implantable subcutaneous lead defibrillator system

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 93261 refers to an in-person interrogation device evaluation specifically for an implantable subcutaneous lead defibrillator system. This procedure involves a comprehensive assessment conducted by a physician or another qualified healthcare professional. The evaluation includes several critical components: the connection of the patient to an electrocardiogram (ECG) monitor, the establishment of a link between the defibrillator device and the interrogation device, and the subsequent interrogation of the defibrillator. During this process, the healthcare professional analyzes and reviews the data obtained from the device to determine its functionality and the current programmed parameters. The evaluation is particularly important when a patient presents with symptoms that may indicate a malfunction of the device or a change in their cardiac function. The procedure encompasses the recording and disconnection of the device, ensuring that all necessary data is captured and assessed. Ultimately, the findings from this interrogation are communicated to the patient, and a detailed report is generated to document the evaluation results.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The in-person interrogation device evaluation using CPT® Code 93261 is indicated for patients who present with symptoms or complaints that may suggest a malfunction of their implantable subcutaneous lead defibrillator system or a change in their cardiac function. This evaluation is crucial for monitoring the device's performance and ensuring patient safety.

  • Device Malfunction Symptoms indicating potential issues with the defibrillator, such as inappropriate shocks or failure to deliver therapy.
  • Change in Cardiac Function Clinical signs that may suggest alterations in the patient's cardiac status, necessitating a review of the device's performance.

2. Procedure

The procedure for CPT® Code 93261 involves several key steps to ensure a thorough evaluation of the implantable subcutaneous lead defibrillator system.

  • Step 1: Patient Connection The patient is first connected to an electrocardiogram (ECG) monitor to facilitate real-time monitoring of cardiac activity. This connection is essential for capturing accurate data during the interrogation process.
  • Step 2: Establishing Connection A connection is then established between the defibrillator device and the interrogation device. This step is critical as it allows the healthcare professional to access the stored data within the defibrillator.
  • Step 3: Interrogation of the Device The defibrillator is interrogated, which involves retrieving and analyzing data related to the device's performance. This includes reviewing the programmed parameters and assessing the overall functionality of the device.
  • Step 4: Data Review The physician or qualified healthcare professional reviews the ECG recordings for any signs of arrhythmia. Additionally, stored data is compared with previous acquisitions to identify any changes or trends in the patient's cardiac events.
  • Step 5: Event Analysis The number and duration of significant events, such as arrhythmias, ectopic beats, and mode switch episodes, are carefully analyzed. This information is vital for understanding the patient's cardiac health and the defibrillator's effectiveness.
  • Step 6: Physiological Data Review The evaluation includes a review of exercise and physiological stress data, noting heart rate adaptations that may indicate how well the patient's heart is responding to various conditions.
  • Step 7: Device Function Assessment The implantable defibrillator system is assessed for its ability to sense and capture cardiac rhythm appropriately. This step ensures that the device is functioning as intended.
  • Step 8: Alert Review Any alerts generated by the device during the evaluation are reviewed to identify potential issues that may require further attention.
  • Step 9: Patient Communication Finally, the patient is informed of the findings from the evaluation, and a written report is generated to document the results and any necessary follow-up actions.

3. Post-Procedure

After the interrogation device evaluation is completed, the patient may be advised on any necessary follow-up appointments or further evaluations based on the findings. The healthcare professional will provide the patient with a written report detailing the results of the interrogation, including any identified issues with the defibrillator system and recommendations for ongoing monitoring or treatment. It is essential for the patient to understand the implications of the findings and any changes that may need to be made to their treatment plan.

Short Descr INTERROGATE SUBQ DEFIB
Medium Descr INTERROGATION EVAL F2F IMPLANT SUBQ LEAD DEFIB
Long Descr Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; implantable subcutaneous lead defibrillator system
Status Code Active 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
Type of Service (TOS) 5 - Diagnostic Laboratory
Berenson-Eggers TOS (BETOS) T2D - Other tests - other
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.
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
77 Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
CR Catastrophe/disaster related
GA Waiver of liability statement issued as required by payer policy, individual case
GC This service has been performed in part by a resident under the direction of a teaching physician
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GW Service not related to the hospice patient's terminal condition
GZ Item or service expected to be denied as not reasonable and necessary
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
TC Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
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2015-01-01 Added Added
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