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A peri-procedural device evaluation is a critical process that involves the assessment and programming of an implantable defibrillator system's parameters in relation to surgical or procedural interventions. This evaluation is conducted either before or after a surgery, procedure, or diagnostic test, ensuring that the device operates optimally during these critical times. The evaluation is performed by a physician or another qualified healthcare professional who is responsible for analyzing, reviewing, and reporting on the device's functionality and settings. During this evaluation, the healthcare provider informs the patient about the necessity of temporarily adjusting the cardiac device parameters. This includes discussing the planned changes to the device settings, the expected duration of these changes, and the timing for restoring the device to its baseline settings or adjusting it to appropriate post-procedure parameters. To facilitate this process, a connection is established between the implantable defibrillator system and a programming device. The healthcare professional interrogates the device to access and review stored data, which encompasses patient-specific information, system parameters, and an evaluation of any leads, sensors, and battery status. Necessary adjustments to the device's programming are made, and subsequent interrogation is performed to confirm that these changes have been successfully implemented. The physician or qualified healthcare professional also evaluates the patient to ensure that they are tolerating the temporary changes well and that their cardiac condition remains stable throughout the procedure. After the surgical or procedural intervention, the patient undergoes a follow-up evaluation, during which the cardiac device parameters may be reverted to their pre-procedure settings if deemed appropriate. The patient is then re-evaluated, and any necessary adjustments are made to ensure optimal device performance. Finally, the patient receives instructions regarding any follow-up services or procedures that may be required post-evaluation.
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The peri-procedural device evaluation and programming of an implantable defibrillator system is indicated for patients undergoing surgical procedures, diagnostic tests, or other interventions where the functionality of the cardiac device may be impacted. The following conditions may warrant this evaluation:
The procedure for peri-procedural device evaluation and programming involves several critical steps to ensure the safety and effectiveness of the implantable defibrillator system:
After the peri-procedural device evaluation and programming, the patient is closely monitored to assess the stability of their cardiac condition and the effectiveness of the device settings. If the device parameters were temporarily adjusted, the healthcare provider will determine the appropriate timing for restoring the device to its baseline settings or making further adjustments as needed. The patient is advised on any follow-up appointments or additional procedures that may be necessary to ensure continued optimal performance of the implantable defibrillator system. Clear instructions are provided to the patient regarding signs and symptoms to watch for, as well as any lifestyle modifications that may be recommended following the procedure.
| Short Descr | PERI-PX DEVICE EVAL & PRGR | Medium Descr | PERI-PX DEV EVAL & PROG SING/DUAL/MULTI LEAD DFB | Long Descr | Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review and report by a physician or other qualified health care professional; single, dual, or multiple lead 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 | Items and Services Packaged into APC Rates | Type of Service (TOS) | 1 - Medical Care | Berenson-Eggers TOS (BETOS) | T2D - Other tests - other | MUE | 2 | 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. | 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. | 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. | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | GC | This service has been performed in part by a resident under the direction of a teaching physician | 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). | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | X3 | Episodic/broad services: for reporting services by clinicians who have broad responsibility for the comprehensive needs of the patient that is limited to a defined period and circumstance such as a hospitalization; reporting clinician service examples include but are not limited to the hospitalist's services rendered providing comprehensive and general care to a patient while admitted to the hospital | 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. | 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. | 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.) | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | CR | Catastrophe/disaster related | 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 | 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 | PO | Excepted service provided at an off-campus, outpatient, provider-based department of a hospital | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | 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 | 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 | 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 |
| 2010-01-01 | Changed | Code description changed. |
| 2009-01-01 | Added | - |
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