Coding Ahead
CasePilot
Medical Coding Assistant
Case2Code
Search and Code Lookup Tool
RedactPHI
HIPAA-Compliant PHI Redaction
DetectICD10CM
ICD-10-CM Code Detection
Log in Register free account
1 code page views remaining. Guest accounts are limited to 1 page view. Register free account to get 5 more views.
Log in Register free account

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 transvenous implantable defibrillator system

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 93284 refers to a comprehensive in-person programming device evaluation specifically for a multiple lead transvenous implantable defibrillator system. This procedure involves a detailed assessment and iterative adjustment of the implantable device to ensure its optimal functionality. During the evaluation, the patient is connected to an electrocardiogram (ECG) monitor, allowing for real-time monitoring of cardiac rhythms. The process includes establishing a connection between the defibrillator system and the programming device, which facilitates the interrogation and review of stored data related to the patient's cardiac rhythm and any tachyarrhythmia episodes. The physician or qualified healthcare professional conducts a thorough analysis, assessing various parameters such as pacing capture thresholds, pacing function, and sensing thresholds across each chamber of the heart. The evaluation also includes testing for cross-talk, which occurs when stimulation in one chamber inadvertently affects another, and assessing for phrenic nerve stimulation during atrial and ventricular stimulation. The iterative programming process is crucial for determining the optimal settings for the device, taking into account the effects on ventricular pacing, hemodynamics, and the heart's overall response. Additionally, the evaluation involves reviewing exercise and physiological stress data to observe heart rate adaptations. Following the assessment, any necessary adjustments to the programmed parameters are made, and reprogramming of the defibrillator system is performed as needed. The patient is then provided with instructions regarding any follow-up services or procedures that may be required.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure associated with CPT® Code 93284 is indicated for patients who require evaluation and adjustment of a multiple lead transvenous implantable defibrillator system. This may include individuals experiencing arrhythmias, those who have undergone recent changes in their cardiac condition, or patients who need optimization of their defibrillator settings to ensure effective pacing and defibrillation. The evaluation is essential for assessing device functionality and ensuring that the programmed values are tailored to the patient's specific cardiac needs.

  • Arrhythmias Patients with documented arrhythmias requiring monitoring and adjustment of their defibrillator settings.
  • Device Optimization Individuals needing fine-tuning of their multiple lead transvenous implantable defibrillator system for improved performance.
  • Recent Cardiac Changes Patients who have experienced recent changes in their cardiac condition that may affect device function.

2. Procedure

The procedure for CPT® Code 93284 involves several critical steps to ensure a thorough evaluation and adjustment of the implantable defibrillator system. Each step is designed to assess the device's functionality and optimize its settings for the patient's needs.

  • Step 1: Patient Connection The patient is connected to an electrocardiogram (ECG) monitor to facilitate real-time monitoring of cardiac rhythms during the evaluation.
  • Step 2: Device Connection A connection is established between the transvenous implantable defibrillator system and the programming device, allowing for data interrogation and review.
  • Step 3: Cardiac Rhythm Assessment The physician assesses the current cardiac rhythm and interrogates stored data related to previous tachyarrhythmia episodes, comparing it with earlier data acquisitions.
  • Step 4: Pacing Capture Threshold Assessment The pacing capture threshold is evaluated in each chamber of the heart to ensure effective pacing.
  • Step 5: Pacing Function Evaluation The pacing function, including the integrity of leads and battery, is assessed, addressing any identified issues.
  • Step 6: Sensing Threshold Data Collection Sensing threshold data is obtained from each chamber to evaluate the device's ability to detect cardiac activity accurately.
  • Step 7: Cross-Talk Evaluation The procedure includes evaluating cross-talk, where stimulation of one chamber may inadvertently activate another chamber.
  • Step 8: Phrenic Nerve Stimulation Testing Atrial and ventricular stimulation is performed to assess the presence or absence of phrenic nerve stimulation, which can affect pacing.
  • Step 9: Iterative Programming Process An iterative programming process is utilized to adjust fixed or dynamic atrioventricular interval timing, optimizing device settings based on the patient's response.
  • Step 10: Review of Exercise and Physiological Data The physician reviews exercise and physiological stress data to note heart rate adaptations and make necessary adjustments to programmed parameters.
  • Step 11: Reprogramming Any necessary reprogramming of the defibrillator system is performed after careful evaluation of all parameters to ensure optimal device performance.
  • Step 12: Patient Instructions Finally, the patient is provided with instructions regarding any required follow-up services or procedures related to their defibrillator system.

3. Post-Procedure

After the completion of the programming device evaluation, the patient may experience a period of monitoring to ensure that the adjustments made to the defibrillator system are effective. The physician will provide specific instructions regarding any follow-up appointments or additional procedures that may be necessary. Patients are advised to report any unusual symptoms or concerns following the procedure, as ongoing assessment of the device's performance is crucial for their safety and health. Regular follow-up evaluations may be scheduled to ensure continued optimal function of the implantable defibrillator system.

Short Descr PRGRMG EVAL IMPLANTABLE DFB
Medium Descr PRGRMG EVAL IMPLANTABLE IN PERSON MULTI 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; multiple 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.
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
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).
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
CR Catastrophe/disaster related
GC This service has been performed in part by a resident under the direction of a teaching physician
PO 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
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.
GW Service not related to the hospice patient's terminal condition
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GZ Item or service expected to be denied as not reasonable and necessary
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.
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).
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.
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
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
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
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
X5 Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician
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
Date
Action
Notes
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 -
Code
Description
Code
Description
Code
Description
Code
Description
Code
Description
CasePilot

Get instant expert-level medical coding assistance.

Ask about:
CPT Codes Guidelines Modifiers Crosswalks NCCI Edits Compliance Medicare Coverage
Example: "What is CPT code 99213?" or "Guidelines for E/M services"