A device clinic can see dozens of pacemaker, ICD and loop recorder patients in a week, and still leave revenue behind. Most of the loss is not from missed visits. It comes from picking an interrogation code that does not match the device, billing a remote period too early, or reporting an in-person check that the remote code already covers.
The cardiac implantable electronic device (CIED) monitoring codes 93279–93298 follow a clear logic once you sort them by three questions: what device the patient has, whether the service was in person or remote, and whether the device was reprogrammed. This guide applies that logic to every code in the family, using the 2026 CPT code set.
Device-Code Matrix: Pacemaker, ICD & Loop Recorder
The device type decides the code row; the setting and service decide the column. Use this matrix as the starting point for every pacemaker interrogation, ICD interrogation and implantable loop recorder claim.
| Device | In person: programming / interrogation | Remote: professional / technical |
|---|---|---|
| Pacemaker, single lead or leadless | 93279 / 93288 | 93294 / 93296 |
| Pacemaker, dual lead | 93280 / 93288 | 93294 / 93296 |
| Pacemaker, multiple lead (CRT-P) | 93281 / 93288 | 93294 / 93296 |
| ICD, single lead transvenous | 93282 / 93289 | 93295 / 93296 |
| ICD, dual lead | 93283 / 93289 | 93295 / 93296 |
| ICD, multiple lead (CRT-D) | 93284 / 93289 | 93295 / 93296 |
| Subcutaneous ICD | 93260 / 93261 | 93295 / 93296 |
| Insertable cardiac monitor (implantable loop recorder) | 93285 / 93291 | 93298, 30 days, covers both |
| Implantable physiologic monitor | None / 93290 | 93297, 30 days, covers both |
Three points prevent most code-selection errors. Count leads, not chambers, for transvenous pacemakers and ICDs. A CRT device is always the multiple-lead code. Loop recorders and physiologic monitors use 30-day remote codes with no separate technical code, so 93296 never applies to them. For some newer leadless systems and therapies, Category III codes apply, such as remote programming of a subcutaneous cardiac rhythm monitor (0650T); check the current manufacturer coding guide and payer policy before billing them.
Programming vs. Interrogation: In-Person Codes
The deciding question for an in-person device check is simple: did anyone change a setting? If a parameter was adjusted, report the programming code. If the device was only read, tested and reviewed, report the interrogation code.
- Programming device evaluation (93279–93285, 93260): Interrogation plus at least one programmed change, for example a 93279 programming evaluation for a single-lead pacemaker. Changes include pacing rate, output, sensing, detection zones or therapy settings. It includes the interrogation, so never add 93288–93291 for the same device at the same encounter.
- Interrogation device evaluation (93288–93291, 93261): Retrieval and review of stored data, battery, lead and sensing checks, and the physician report, without reprogramming. Pacemaker interrogation CPT 93288 and ICD interrogation 93289 are the most frequently billed codes in this group.
- Wearable defibrillator (93292): Interrogation of a wearable cardioverter-defibrillator, including data review and report.
The documentation must support the choice. A note that says “device checked, no changes” supports interrogation only. For programming, record the parameter, its value before and after, and why it was changed. Payers that review device claims look for that before-and-after detail when a programming code is billed repeatedly.
In-person codes are reported per encounter and carry professional and technical components. In a hospital outpatient department, the physician bills the professional component of the device check with modifier 26, and the hospital bills the technical component on its facility claim. In the office, the practice bills the global code. For a broader view of how component billing works across cardiology services, see our guide to medical coding for cardiology.
Remote Monitoring Codes & Service Periods
Remote device codes are period-based, not transmission-based, which is what makes 90-day remote monitoring billing different from in-person device checks. One claim covers every transmission, interim analysis and report in the period, no matter how many alerts arrive.
| Code | Device | Period, minimum and component |
|---|---|---|
| 93294 | Pacemaker, including leadless | Up to 90 days; minimum 30 days; professional only |
| 93295 | ICD, including subcutaneous | Up to 90 days; minimum 30 days; professional only |
| 93296 | Pacemaker or ICD | Up to 90 days; minimum 30 days; technical only |
| 93297 | Implantable physiologic monitor | Up to 30 days; minimum 10 days; global, or split with 26/TC |
| 93298 | Insertable cardiac monitor | Up to 30 days; minimum 10 days; global, or split with 26/TC |
These limits come straight from the code guidance: the 90-day codes are reported no more than once every 90 days and not for a period shorter than 30 days, and the 30-day codes no more than once every 30 days and not for a period shorter than 10 days.
A patient who enrolls in remote monitoring and then has a generator change at day 20 has not reached a billable 90-day period.
Bill at the end of the period, once the interim analysis and report are complete, and keep the period start and end dates in the record.
Confirm how your MAC wants the date of service reported, because billing the next period before the previous one closes is the most common reason remote claims deny as duplicates. Because 93294 and 93295 are already professional-only codes, modifier 26 is never added to them.
Who Bills 93296: Technical vs. Professional Service
93296 pays for the technical side of pacemaker and ICD remote monitoring: receiving transmissions, technician review, triage and distribution of results. 93294 and 93295 pay for the physician or qualified health care professional analysis and report. They are separate codes, so the question is who furnished each part.
| Setting | 93294 or 93295 | 93296 |
|---|---|---|
| Practice runs its own remote clinic | Practice | Practice |
| Hospital-based device clinic | Physician, on the professional claim | Hospital, on the facility claim |
| Independent monitoring service under contract | Physician | Entity that furnished and can bill the technical service, per contract and payer enrollment |
A device manufacturer network that only hosts transmissions does not make the service billable by the manufacturer, and it does not move 93296 to the physician unless the practice actually performs the technical review.
When an outside service bills 93296, the practice must not bill it as well, or one of the claims will deny as a duplicate. Remote monitoring can be furnished under general supervision, while in-person device evaluations in the office require direct supervision. Getting this split right is the foundation of CIED remote monitoring reimbursement.
Periprocedural Checks and Implant Code Bundling
93286 (pacemaker, including leadless) and 93287 (ICD) cover an in-person evaluation and programming done immediately before or after a separate surgery, procedure or test, such as suspending tachy therapies before surgery with electrocautery, or setting MRI mode before a scan and restoring settings after.
- Before and after count separately. When the device is evaluated before the procedure and again after it, report the code twice for that procedure.
- Not with other device evaluations for the same session. 93286 and 93287 already include interrogation and programming, so do not add 93279–93289 for the same device at that encounter.
- Not with the implant itself. The testing and programming done during a pacemaker or ICD insertion, generator change or lead revision is part of the implant procedure, not a periprocedural evaluation.
- Watch electrophysiology procedures. CPT also restricts 93286 and 93287 with certain ablation codes, so run NCCI edits before billing them with EP lab services.
The key documentation is the reason for the evaluation and the procedure it supported. Without it, a periprocedural code looks like an unsupported second interrogation and is likely to deny.
Frequency Limits, Overlaps and Same-Day E/M
Most device interrogation denials come from overlap: two codes that pay for the same data in the same period. These are the combinations to check before every claim.
| Situation | Rule | Billing action |
|---|---|---|
| In-person interrogation during an active remote period, same device | CPT does not allow 93288 with 93294, 93289 with 93295, or 93291 with 93298 for the same period | Do not bill the interrogation separately |
| In-person reprogramming during a remote period | Programming codes are not part of the remote code | Bill 93279–93285 when a setting was changed and documented |
| Remote period shorter than the minimum | Under 30 days (90-day codes) or 10 days (30-day codes) | Hold until the minimum is met, or do not bill |
| Second remote claim inside the same period | Once per 90 or 30 days | Align the new period start date before billing |
| Device check and office visit, same day | Device evaluation does not include E/M | Bill E/M with modifier 25 only when a separate, significant problem was managed |
Modifier 25 needs its own medical decision making. Adjusting medications for heart failure symptoms or evaluating new syncope supports a separate E/M; reviewing the device report with the patient does not. For more on modifier use and documentation standards across the specialty, see our cardiology coding guidelines and best practices.
A Remote Clinic Workflow That Captures Every Period
Remote monitoring is recurring revenue, but only if every enrolled patient produces a claim at the end of every period. The workflow below closes the gaps where remote device revenue usually leaks.
Enroll and track every device
Keep a device registry with the patient, device type, lead count, manufacturer network and remote enrollment date. The enrollment date anchors the first period, and the device type picks the code row from the matrix above. Update it after every generator change, upgrade or explant.
Close each period on schedule
Run a weekly report of periods ending in the next seven days. Confirm the interim report is signed, the minimum monitoring days are met and no in-person interrogation was billed for the same period. Then release 93294 or 93295 with 93296, or 93297 or 93298, as the setting allows.
Code the diagnosis to the device and the reason
Pair the device status code, such as Z95.0 for a pacemaker or Z95.810 for an ICD, with the condition being monitored. Use Z45.010, Z45.018 or Z45.02 when the encounter is specifically for checking or adjusting the device. Alert-driven transmissions should also carry the arrhythmia or finding that triggered them.
Audit the denials monthly
Group device denials by reason: duplicate period, frequency, missing modifier 26, or E/M overlap. A single recurring pattern usually points to one broken step. Our article on how cardiac diagnostic billing experts capture payment explains how to verify monitoring data before billing, and the cardiology billing cheat sheet is a quick reference for the codes that sit alongside device checks.
Let the Device, Setting and Period Choose the Code
Device interrogation coding stops being confusing when every claim answers three questions in order: which device, in person or remote, and was anything reprogrammed. Add the service-period rules, the 93296 ownership question and a clean modifier 25 policy, and a device clinic can bill every check it performs without overlapping claims.
The practices that profit most from remote monitoring are the ones that close every 30- and 90-day period on time.
If remote periods are slipping or device claims keep denying as duplicates, MBW RCM can help. Our cardiology billing services specialists track device registries, close monitoring periods on schedule and audit interrogation claims before they reach the payer.
Frequently Asked Questions
What is the CPT code for a pacemaker interrogation?
An in-person pacemaker interrogation without reprogramming is 93288. If a setting is changed, report the programming code instead: 93279, 93280 or 93281 based on the number of leads. Remote pacemaker monitoring uses 93294 for the professional service and 93296 for the technical service.
What is the difference between 93289 and 93295?
93289 is an in-person ICD interrogation reported per encounter. 93295 is the professional service for remote ICD monitoring, reported once per period of up to 90 days.
Can 93294 and 93296 be billed together?
Yes. When the practice performs both the physician analysis and the technical remote service, it bills 93294 with 93296 for the same 90-day period. If a hospital or contracted service furnishes the technical service, only that entity bills 93296.
How often can 93298 be billed for a loop recorder?
No more than once every 30 days, and not when the monitoring period is shorter than 10 days. 93298 covers both the technical and professional work unless the service is split with modifiers TC and 26.
Do device interrogation codes need modifier 26?
Only the global codes do, when the physician performs the service in a facility. Use modifier 26 on in-person codes such as 93288 and on 93297 or 93298 in that setting. Never add it to 93294 or 93295, which are already professional-only codes.
Can an office visit be billed on the same day as a device check?
Yes, with modifier 25 on the E/M, when the provider managed a separate, significant problem beyond reviewing the device. Device review alone does not support a separate visit.