ZIO PATCHES
Duration < 7 Days
93242
93244
Duration > 7 Days
93246
93248
INPATIENT
INITIAL CONSULTATION
(High) 99255 - 80 min
(Mod) 99254 - 60 min
(Low) 99253 - 45 min
ADMISSION HPI (PRIMARY)
High: 99223 - 75 min
Mod: 99222 - 55 min
Low: 99221 - 40 min
SUBSEQUENT ENCOUNTER
Unstable or New - 99233
Mod - 99232
Low Complexity - 99231
CCU
99291 - 30-74 min
99292 - each additional 30 minutes
DISCHARGE (PRIMARY)
99238: < 30 minutes
99239: > 30 minutes
TELEPHONIC VISITS
New Patient:
●98000 Synchronous audio-video visit for the evaluation and management of a new patient, which
requires a medically appropriate history and/or examination and straightforward medical decision making.
When using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.
●98001 Synchronous audio-video visit for the evaluation and management of a new patient, which
requires a medically appropriate history and/or examination and low medical decision making.
When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.
●98002 Synchronous audio-video visit for the evaluation and management of a new patient, which
requires a medically appropriate history and/or examination and moderate medical decision making.
When using total time on the date of the encounter for code selection, 45 minutes must be met or
exceeded.
●98003 Synchronous audio-video visit for the evaluation and management of a new patient, which
requires a medically appropriate history and/or examination and high medical decision making.
When using total time on the date of the encounter for code selection, 60 minutes must be met or
exceeded.
Established Patient:
●98004 Synchronous audio-video visit for the evaluation and management of an established
patient, which requires a medically appropriate history and/or examination and straightforward medical decision making.
When using total time on the date of the encounter for code selection, 10 minutes must be met or exceeded.
●98005 Synchronous audio-video visit for the evaluation and management of an established
patient, which requires a medically appropriate history and/or examination and low medical decision making.
When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.
●98006 Synchronous audio-video visit for the evaluation and management of an established
patient, which requires a medically appropriate history and/or examination and moderate medical decision making.
When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.
●98007 Synchronous audio-video visit for the evaluation and management of an established
patient, which requires a medically appropriate history and/or examination and high medical decision making.
When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.
**** If the MD/NP/PA “Telephone call/Audio only” Provider Service is less than 5 minutes, the CPT code would be 98016 for “Brief communication” and is no longer noted with “Telephone” verbiage****
CPT CODES - Devices
New PPM
-SC-PPM: 33207 (Ventricular) or 33206 (Atrial)
-DC-PPM: 33208
-CRT-P: 33208 + 33224 (33225)
NEW ICD
-SC-ICD: 33249
-DC-ICD: 33249
-Bi-V ICD: 33225
Reposition Leads (A or V) within 90 days of implant: 33215
996.01 – Pacemaker Lead
996.04 – ICD Lead
DFT Test – 93641
Pocket Revision: 33222
Temporary PM (Single lead): 33210
Lead Revision: 33218
ILR Implantation: 33285
ILR Removal: 33286
Bi-V ICD Reprogram - 93824
Generator Changes
SC-PPM: 33212 (996.01)
DC-PPM: 33213 (996.01)
CRT-P PPM: (996.01)
SC-ICD: 33240 (996.04)
DC-ICD: 33230 (996.04)
BI-V ICD: 33231 (996.04)
Explant Generator
SC PPM: 33227
DC-PPM: 33228
CRT-P: 33229
SC-ICD: 33262
DC-ICD: 33263
BiV ICD: 33264
Removal of PPM only 33233
Upgrades:
-SC-PPM DC-PPM: 33214
-SC ICD DC ICD: 33249
-DC-PPM DC-ICD: 33249
-Bi-V Upgrade: 33225 (for surgeon 33224)
Extractions:
-Single Lead extraction (A or V): 33234
-Dual Lead Extraction: 33244
CPT CODES ABLATIONS:
DCCV (external): 92960
DCCV (Internal): 92961
A-line: 36620
EPS:
-Comprehensive: 93620 (37.26)
-Limited: 93600
-Follow up: 93624 (37.26)
Drug Infusion: 93623
3D Mapping: 93609 (37.27)
-Old code: 93613
Intracardiac Echocardiography (ICE): 93662 (37.28)
AVN Ablation: 93650 (37.34)
SVT (SVT / Atrial Flutter) Ablation: 93653 (37.34)
-Must document:
-Induction or attempted induction of arrhythmia
-RA pacing and Recording
-RV pacing and recording
-His recording
Atrial Fibrillation:
PVI: 93656
Must document:
-Pulmonary vein isolation
-Multiple transeptals
-Induction or attempted induction of arrhythmia
-RA and LA pacing and recording
-RV pacing and recording
-His bundle recording
Additional Lines: 93657
Transeptal Puncture: 93462
-Has to be used with:
93452: Left Heart Catherizaion
93453 (SVT Ablation)
93654 (VT)
93458-93461
VT / PVC Ablation: 93654 (37.34)