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Cardiology Coding Alert

CPT® 2019:
Gear Up for Cardiac Rhythm Monitor Additions, Interrogation & Programming Device Revisions

Don’t miss new codes 33285 and 33286.

From cardiac rhythm monitor additions, to new transcatheter codes, to several interrogation and programming device revisions, you want to make sure your practice is ready for CPT® 2019. Although these changes won’t become effective until January 1, 2019, now is the perfect time to start prepping.

Preparing for CPT® 2019 is important because you need to know the new codes, how the old ones are affected, and if the new codes for new procedures graduated from “T-codes,” says Jim Pawloski, BS, MSA, CIRCC, R.T. (R)(CV), coder at William Beaumont Hospital in Royal Oak, Michigan, and Adreima in Phoenix, Arizona.

To prepare, Pawloski says he keeps up with different professional societies to see if there are any discussion of new codes that may be coming.

Goodbye 33282 and 33284, Hello New Codes 33285 or 33286

Additions: CPT® 2019 has added the following two new cardiac rhythm monitor codes:

  • »33285 (Insertion, subcutaneous cardiac rhythm monitor, including programming)
  • 33286 (Removal, subcutaneous cardiac rhythm monitor).

Don’t miss: CPT® 2019 has deleted codes 33282 (Implantation of patient-activated cardiac event recorder) and 33284 (Removal of an implantable, patient-activated cardiac event recorder). Now, you should report new codes 33285 or 33286 instead.

Add 2 New Transcatheter Choices to Your Coding Arsenal

Additions: CPT® 2019 will add the following two new transcatheter codes:

  • 33274 (Transcatheter insertion or replacement of permanent leadless pacemaker, right ventricular, including imaging guidance (eg, fluoroscopy, venous ultrasound, ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed)
  • 33275 (Transcatheter removal of permanent leadless pacemaker, right ventricular).

Take a Look at These Interrogation and Programming Device Revisions

For the following codes, CPT® 2019 will add “leadless pacemaker system” to the descriptors. (Additions are underlined for emphasis.):

  • 93279 (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; single lead pacemaker system or leadless pacemaker system in one cardiac chamber). Don’t miss: This descriptor also specifies “in one cardiac chamber.”
  • »93288 (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; single, dual, or multiple lead pacemaker system, or leadless pacemaker system). For 93288, the leadless pacemaker system was added to the evaluation of the different pacemaker system, according to Pawloski. This code replaces 0391T (Interrogation device evaluation (in person) with analysis, review and report, includes connection, recording and disconnection per patient encounter, leadless pacemaker system).
  • 93294 (Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead pacemaker system, or leadless pacemaker system with interim analysis, review(s) and report(s) by a physician or other qualified health care professional)
  • 93296 (… single, dual, or multiple lead pacemaker system, leadless pacemaker system, or implantable defibrillator system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results)

In addition, the following codes add “physiologic” to their descriptors. (Additions are underlined for emphasis.):

  • 93290 (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 cardiovascular physiologic monitor system, including analysis of 1 or more recorded physiologic cardiovascular data elements from all internal and external sensors)
  • 93297 (Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, including analysis of 1 or more recorded physiologic cardiovascular data elements from all internal and external sensors, analysis, review(s) and report(s) by a physician or other qualified health care professional).

Also, the descriptors for the following codes will delete “implantable loop recorder system” and add “subcutaneous cardiac rhythm monitor system.” In addition to those changes, you will notice that 93299 also adds “physiologic” to its descriptor. (Additions are underlined for emphasis, and deletions are struck out.) Check out these changes below:

  • 93285 (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; implantable loop recorder system subcutaneous cardiac rhythm monitor system)

93291 (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 loop recorder system subcutaneous cardiac rhythm monitor system, including heart rhythm derived data analysis)

  • 93298 (Interrogation device evaluation(s), (remote) up to 30 days; implantable loop recorder systems subcutaneous cardiac rhythm monitor system, including analysis of recorded heart rhythm data, analysis, review(s) and report(s) by a physician or other qualified health care professional).
  • 93299 (Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system or implantable loop recorder system subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results).