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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; dual lead transvenous implantable defibrillator system

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 93283 refers to the in-person programming device evaluation of a dual lead transvenous implantable defibrillator system. This procedure involves a comprehensive assessment where the healthcare professional iteratively adjusts the implantable device to ensure optimal functionality. The evaluation includes testing the device's performance and selecting the best permanent programmed values. During this process, the patient is connected to an electrocardiogram (ECG) monitor, allowing for real-time monitoring of cardiac activity. The healthcare provider establishes a connection between the defibrillator system and the programming device to facilitate the evaluation. Key aspects of the procedure include assessing the cardiac rhythm, reviewing current stored data related to previous tachyarrhythmia episodes, and comparing this data with earlier acquisitions. The evaluation also involves determining the pacing capture threshold in each chamber, assessing the pacing function, and addressing any issues related to leads or battery integrity. Additionally, the procedure evaluates sensing thresholds and cross-talk, which occurs when stimulation in one chamber inadvertently affects another. Atrial and ventricular stimulation tests are performed to check for phrenic nerve stimulation. The iterative programming process is crucial for adjusting parameters such as the atrioventricular interval timing, based on the effects observed on ventricular pacing and overall heart response. The healthcare professional reviews exercise and physiological stress data to note heart rate adaptations and makes necessary adjustments to the programmed parameters. After a thorough evaluation, any required reprogramming of the defibrillator system is conducted, and the patient receives instructions regarding follow-up services or procedures. This code is specifically designated for dual lead systems, while separate codes exist for single lead and multiple lead systems.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure associated with CPT® Code 93283 is indicated for patients who require evaluation and adjustment of a dual lead transvenous implantable defibrillator system. The following conditions may warrant this procedure:

  • Cardiac Arrhythmias Patients experiencing arrhythmias that necessitate monitoring and adjustment of their defibrillator settings.
  • Device Functionality Issues Situations where there are concerns regarding the performance or functionality of the implantable defibrillator.
  • Post-Implantation Assessment Evaluation following the implantation of a dual lead defibrillator to ensure optimal programming and device performance.
  • Adjustment of Therapy Patients requiring modifications to their defibrillator settings based on changes in their clinical status or response to therapy.

2. Procedure

The procedure for CPT® Code 93283 involves several critical steps to ensure the effective programming and evaluation of the dual lead transvenous implantable defibrillator system:

  • Step 1: Patient Preparation The patient is prepared for the procedure by connecting them to an electrocardiogram (ECG) monitor to continuously assess cardiac rhythm during the evaluation.
  • Step 2: Device Connection A connection is established between the implantable defibrillator system and the programming device, allowing for data transfer and adjustments to be made.
  • Step 3: Cardiac Rhythm Assessment The healthcare professional assesses the current cardiac rhythm, which is crucial for understanding the patient's heart function and determining necessary adjustments.
  • Step 4: Data Interrogation Current stored data related to cardiac rhythm and any tachyarrhythmia episodes is interrogated and reviewed, comparing it with previous data to identify any changes or issues.
  • Step 5: Pacing Capture Threshold Assessment The pacing capture threshold is assessed in each chamber of the heart to ensure effective pacing and to identify any potential issues.
  • Step 6: Pacing Function Evaluation The pacing function is evaluated, including the integrity of leads and battery status, to ensure the device is functioning correctly.
  • Step 7: Sensing Threshold Data Collection Sensing threshold data is obtained from each chamber to evaluate the device's ability to detect cardiac signals accurately.
  • Step 8: Cross-Talk Evaluation The procedure includes evaluating cross-talk, which occurs when stimulation in one chamber affects another, ensuring that the device operates without interference.
  • Step 9: Atrial and Ventricular Stimulation Atrial and ventricular stimulation tests are performed to check for the presence or absence of phrenic nerve stimulation, which can affect pacing.
  • Step 10: Iterative Programming Process An iterative programming process is utilized to adjust fixed or dynamic atrioventricular interval timing, optimizing the device settings based on observed effects on ventricular pacing and hemodynamics.
  • Step 11: Review of Exercise and Physiological Data The healthcare professional reviews exercise and physiological stress data to note heart rate adaptations, which inform further adjustments to the device settings.
  • Step 12: Parameter Adjustment Programmed parameters are adjusted as needed based on the comprehensive evaluation of the device's performance and the patient's response.
  • Step 13: Reprogramming Any necessary reprogramming of the defibrillator system is performed after careful evaluation of all parameters to ensure optimal device function.
  • Step 14: Patient Instructions Finally, the patient is provided with instructions regarding any required follow-up services or procedures to ensure ongoing monitoring and care.

3. Post-Procedure

After the completion of the procedure associated with CPT® Code 93283, the patient may be monitored for a short period to ensure stability and proper functioning of the defibrillator system. The healthcare professional will provide the patient with detailed instructions regarding any follow-up appointments, potential symptoms to monitor, and when to seek further medical attention. It is essential for the patient to adhere to these instructions to ensure the continued effectiveness of the defibrillator and to address any issues that may arise post-evaluation. Regular follow-up evaluations may be necessary to reassess the device settings and overall cardiac health.

Short Descr PRGRMG EVAL IMPLANTABLE DFB
Medium Descr PRGRMG EVAL IMPLANTABLE IN PRSN DUAL LEAD DFB
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; dual lead transvenous implantable 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) 1 - Medical Care
Berenson-Eggers TOS (BETOS) T2D - Other tests - other
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).
GC This service has been performed in part by a resident under the direction of a teaching physician
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
PN Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital
GA Waiver of liability statement issued as required by payer policy, individual case
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.
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
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).
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
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m 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.
27 Multiple outpatient hospital e/m encounters on the same date: for hospital outpatient reporting purposes, utilization of hospital resources related to separate and distinct e/m encounters performed in multiple outpatient hospital settings on the same date may be reported by adding modifier 27 to each appropriate level outpatient and/or emergency department e/m code(s). this modifier provides a means of reporting circumstances involving evaluation and management services provided by physician(s) in more than one (multiple) outpatient hospital setting(s) (eg, hospital emergency department, clinic). note: this modifier is not to be used for physician reporting of multiple e/m services performed by the same physician on the same date. for physician reporting of all outpatient evaluation and management services provided by the same physician on the same date and performed in multiple outpatient setting(s) (eg, hospital emergency department, clinic), see evaluation and management, emergency department, or preventive medicine services codes.
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.)
93 Synchronous telemedicine service rendered via telephone or other real-time interactive audio-only 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 away 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 is sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction.
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.
AO Alternate payment method declined by provider of service
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
FS Split (or shared) evaluation and management visit
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
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
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
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
Q5 Service furnished under a reciprocal billing arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
Q6 Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
SA Nurse practitioner rendering service in collaboration with a physician
UD Medicaid level of care 13, as defined by each state
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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2015-01-01 Changed Description Changed
2013-01-01 Changed Description Changed
2011-01-01 Changed Short description changed.
2010-01-01 Changed Code description changed.
2009-01-01 Added -
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