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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; multiple lead pacemaker system

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

A programming device evaluation is a critical procedure performed on a multiple lead pacemaker system. This evaluation involves an in-person assessment where the healthcare professional conducts iterative adjustments to the implantable device. The primary goal is to test the device's function and select optimal permanent programmed values. During this process, the patient is connected to an electrocardiogram (ECG) monitor, allowing for real-time assessment of cardiac rhythm. The healthcare provider establishes a connection between the pacemaker device and the programming device to facilitate this evaluation.

Throughout the procedure, the healthcare professional analyzes and reviews the data collected from the device, which includes a comprehensive report detailing the findings. The evaluation encompasses a thorough review of summary data and recorded rhythm data to identify any evidence of arrhythmias. Additionally, stored pacemaker data is retrieved to assess the current programming of the device, ensuring that the pacemaker's capture and sensing functions are operating correctly, along with an evaluation of the leads and battery status.

Key parameters such as rhythm alerts, tachycardia detection, and treatment settings are meticulously noted. The pacing capture threshold is measured, and various parameters including voltage, lead impedance, and pulse width are reviewed to ensure optimal device performance. The sensing threshold is also measured and adjusted as necessary to enhance the device's functionality. Furthermore, the healthcare professional reviews exercise and physiologic stress data, noting heart rate adaptations and making adjustments to programmed parameters as needed. If any reprogramming of the device is required, it is performed after a careful evaluation of all programmed parameters. Finally, the patient receives instructions regarding any necessary follow-up services or procedures to ensure continued monitoring and care.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The programming device evaluation (CPT® Code 93281) is indicated for patients with a multiple lead pacemaker system. This procedure is performed to ensure the proper functioning of the device and to optimize its programmed settings. The following conditions may warrant this evaluation:

  • Assessment of Cardiac Rhythm: Patients experiencing irregular heart rhythms or arrhythmias may require this evaluation to ensure the pacemaker is functioning correctly.
  • Device Optimization: Patients who need adjustments to their pacemaker settings for improved cardiac function or symptom relief.
  • Post-Implantation Evaluation: Following the implantation of a multiple lead pacemaker, an evaluation is necessary to confirm that the device is programmed correctly and is capturing the heart's electrical signals effectively.
  • Routine Follow-Up: Regular evaluations are indicated for patients with existing pacemakers to monitor device performance and make necessary adjustments.

2. Procedure

The procedure for programming device evaluation involves several detailed steps to ensure comprehensive assessment and optimization of the pacemaker system. The following steps outline the process:

  • Step 1: Patient Connection to ECG Monitor - The patient is connected to an electrocardiogram (ECG) monitor to continuously assess cardiac rhythm during the evaluation. This connection is crucial for real-time monitoring of the heart's electrical activity.
  • Step 2: Establishing Connection with Programming Device - A connection is established between the pacemaker device and the programming device. This allows the healthcare professional to access the pacemaker's stored data and make necessary adjustments.
  • Step 3: Assessment of Cardiac Rhythm - The healthcare provider assesses the cardiac rhythm through the ECG monitor, looking for any irregularities or arrhythmias that may require attention.
  • Step 4: Review of Summary and Recorded Data - Summary data and recorded rhythm data are reviewed to identify any evidence of arrhythmias. This step is essential for understanding the device's performance and the patient's cardiac status.
  • Step 5: Retrieval of Stored Pacemaker Data - The healthcare professional retrieves stored data from the pacemaker to evaluate its current programming, including capture and sensing functions, lead status, and battery condition.
  • Step 6: Assessment of Rhythm Alerts and Parameters - Rhythm alerts and parameters are noted, including settings for tachycardia detection and treatment, to ensure the device is programmed to respond appropriately to abnormal rhythms.
  • Step 7: Measurement of Pacing Capture Threshold - The pacing capture threshold is measured to determine the minimum electrical output required to stimulate the heart effectively. This measurement is critical for ensuring the pacemaker's efficacy.
  • Step 8: Review of Voltage, Lead Impedance, and Pulse Width - Various parameters, including voltage, lead impedance, and pulse width, are reviewed to ensure optimal device performance and patient safety.
  • Step 9: Measurement and Adjustment of Sensing Threshold - The sensing threshold is measured and adjusted as needed to enhance the device's ability to detect the heart's electrical signals accurately.
  • Step 10: Review of Exercise and Physiologic Stress Data - The healthcare professional reviews data related to exercise and physiological stress to understand how the pacemaker performs under different conditions and to note heart rate adaptations.
  • Step 11: Adjustment of Programmed Parameters - Based on the evaluations, programmed parameters are adjusted as necessary to optimize the pacemaker's performance for the patient's needs.
  • Step 12: Reprogramming of the Device - If required, any necessary reprogramming of the device is performed after a thorough evaluation of all programmed parameters to ensure the best possible outcomes for the patient.
  • Step 13: Patient Instructions for Follow-Up - After the evaluation, the patient is provided with instructions regarding any required follow-up services or procedures to ensure ongoing monitoring and care.

3. Post-Procedure

Post-procedure care following the programming device evaluation includes monitoring the patient for any immediate reactions to the adjustments made to the pacemaker. The healthcare professional will provide the patient with specific instructions regarding follow-up appointments, any necessary lifestyle modifications, and signs or symptoms to watch for that may indicate issues with the pacemaker. Patients are encouraged to report any unusual symptoms, such as palpitations, dizziness, or changes in their heart rhythm, to their healthcare provider promptly. Regular follow-up evaluations are essential to ensure the pacemaker continues to function optimally and to make any further adjustments as needed.

Short Descr PM DEVICE PROGR EVAL MULTI
Medium Descr PROGRAM EVAL IMPLANTABLE IN PRSN MULTI LD PACER
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; multiple lead pacemaker 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) 1 - Medical Care
Berenson-Eggers TOS (BETOS) T2C - Other tests - EKG monitoring
MUE 1
CCS Clinical Classification 203 - Electrographic cardiac monitoring
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.
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
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.
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).
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
CR Catastrophe/disaster related
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
GA Waiver of liability statement issued as required by payer policy, individual case
GW Service not related to the hospice patient's terminal condition
23 Unusual anesthesia: occasionally, a procedure, which usually requires either no anesthesia or local anesthesia, because of unusual circumstances must be done under general anesthesia. this circumstance may be reported by adding modifier 23 to the procedure code of the basic service.
24 Unrelated evaluation and management service by the same physician or other qualified health care professional during a postoperative period: the physician or other qualified health care professional may need to indicate that an evaluation and management service was performed during a postoperative period for a reason(s) unrelated to the original procedure. this circumstance may be reported by adding modifier 24 to the appropriate level of e/m service.
25 Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service: it may be necessary to indicate that on the day a procedure or service identified by a cpt code was performed, the patient's condition required a significant, separately identifiable e/m service above and beyond the other service provided or beyond the usual preoperative and postoperative care associated with the procedure that was performed. a significant, separately identifiable e/m service is defined or substantiated by documentation that satisfies the relevant criteria for the respective e/m service to be reported (see evaluation and management services guidelines for instructions on determining level of e/m service). the e/m service may be prompted by the symptom or condition for which the procedure and/or service was provided. as such, different diagnoses are not required for reporting of the e/m services on the same date. this circumstance may be reported by adding modifier 25 to the appropriate level of e/m service. note: this modifier is not used to report an e/m service that resulted in a decision to perform surgery. see modifier 57 for significant, separately identifiable non-e/m services, see modifier 59.
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).
57 Decision for surgery: an evaluation and management service that resulted in the initial decision to perform the surgery may be identified by adding modifier 57 to the appropriate level of e/m service.
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.
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.
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
95 Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system.
99 Multiple modifiers: under certain circumstances 2 or more modifiers may be necessary to completely delineate a service. in such situations modifier 99 should be added to the basic procedure, and other applicable modifiers may be listed as part of the description of the service.
DA Oral health assessment by a licensed health professional other than a dentist
FS Split (or shared) evaluation and management visit
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
GY Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
GZ Item or service expected to be denied as not reasonable and necessary
KX Requirements specified in the medical policy have been met
PD Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days
PN Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital
PO Excepted service provided at an off-campus, outpatient, provider-based department of a hospital
Q0 Investigational clinical service provided in a clinical research study that is in an approved clinical research study
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
TV Special payment rates, holidays/weekends
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
XP Separate practitioner, a service that is distinct because it was performed by a different practitioner
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
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2011-01-01 Changed Short description changed.
2010-01-01 Changed Code description changed.
2009-01-01 Added -
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