Summary & Overview
CPT 0418T: Implantable CCM System Interrogation and Evaluation
CPT code 0418T covers an in-person interrogation and evaluation of an implantable cardiac contractility modulation (CCM) system, including connecting and disconnecting device components, recording results, and reporting analysis of programmed settings. This procedure is clinically important as CCM systems are used for select patients with heart failure to improve cardiac contractility; accurate device interrogation supports ongoing device function, safety, and optimized therapy delivery. Nationally, clear coding for device interrogation ensures consistent clinical documentation and claims processing for outpatient device management.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the code’s clinical purpose and service setting, an overview of payer coverage context, and practical benchmarking and policy considerations relevant to hospital outpatient departments and cardiac device clinics. The publication summarizes common modifiers and reporting context, outlines where to expect this service to appear on the claim line, and highlights clinical implications for device-dependent patients. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 0418T describes an in-person evaluation and interrogation of an implantable cardiac contractility modulation (CCM) system. The service includes connecting and disconnecting the device components, recording interrogation results, and performing analysis, review, and a reported evaluation of the device’s programmed settings. This code is reportable for each patient encounter in which the CCM system is interrogated.
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Service type: Device interrogation and programming evaluation
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Typical site of service: Hospital outpatient department, cardiac device clinic, or other outpatient clinic settings where device interrogation and programming are performed
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 68-year-old male with chronic systolic heart failure (left ventricular ejection fraction 25%) and New York Heart Association (NYHA) class III symptoms presents for routine device follow-up after implantation of an implantable cardiac contractility modulation (CCM) system. The patient reports persistent exertional dyspnea and fatigue despite guideline-directed medical therapy. The provider performs an in-person interrogation of the CCM device: connecting external programmer leads to the implanted pulse generator and lead connectors, verifying lead integrity and signal quality, recording device telemetry and therapy delivery logs, evaluating programmed CCM parameters, and documenting findings. The clinical workflow includes device interrogation in an outpatient cardiology or electrophysiology clinic or ambulatory surgery center; assessment of device function, therapy delivery percentage, sensing/impedance values, and battery status; adjustment of CCM programming if indicated; and generation of a written report placed in the medical record and communicated to the referring cardiologist and the patient. The encounter may involve reprogramming, troubleshooting lead problems, or deciding on further interventions such as lead revision or device replacement based on the interrogation results.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the physician interpretation and report separate from technical component. |
TC | Technical component | Use when reporting only the device/technical component, typically by the facility or technician. |
59 | Distinct procedural service | Data not available in the input. |
52 | Reduced services | Use when the interrogation or procedure is partially reduced or not completed as typically performed. |
53 | Discontinued procedure | Use when the device interrogation is started but discontinued due to patient instability or technical failure. |
62 | Two surgeons | Use when two physicians with different specialties are required for the encounter (rare for CCM interrogation). |
78 | Return to OR (unplanned) | Use when an interrogation leads to an unplanned return to procedure for device revision during the same global period. |
80 | Assistant surgeon | Use when an assistant surgeon participates and billing circumstances allow reporting of assistant services. |
81 | Minimum assistant surgeon | Use when a minimum assistant surgeon provides assistance during a device-related procedure. |
AS | Physician assistant, nurse practitioner, or clinical nurse specialist | Use when an APC (advanced practice clinician) performs services in states/payors that allow direct billing under their NPI. |
QK | Medical direction of two or three assistants | Use when the physician medically directs qualified assistants during a related operative service. |
QX | Service performed by an assistant surgeon (modifier) | Use when an assistant surgeon performs part of a related operative service. |
QY | Attending physician documented and billed | Use when required by payor rules for supervision/teaching settings. |
TG | Rural health clinic or FQHC substitute payment | Use when services are billed under specific clinic reimbursement rules. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207RH0000X | Cardiovascular Disease (Cardiologist) | Electrophysiology and device management in outpatient/electrophysiology clinic. |
| 207RT0004X | Cardiac Electrophysiology | Specialists who implant, interrogate, and program CCM systems. |
| 208000000X | Cardiology | General cardiologists who manage heart failure clinics and device follow-up. |
| 363L00000X | Physician Assistant | APCs who may perform device interrogations under physician supervision. |
| 367A00000X | Registered Nurse (RN) — Electrophysiology | Nursing staff who assist with device connections and technical data collection. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
I50.22 | Chronic systolic (congestive) heart failure | Common indication for CCM therapy to improve symptoms in patients with reduced ejection fraction. |
I50.23 | Acute on chronic systolic (congestive) heart failure | Relevant for patients with worsening symptoms who require device assessment. |
I50.9 | Heart failure, unspecified | General code used when heart failure type is not otherwise specified during device follow-up. |
I25.10 | Atherosclerotic heart disease of native coronary artery without angina pectoris | Comorbid ischemic cardiomyopathy often present in patients receiving CCM devices. |
I42.0 | Dilated cardiomyopathy | Etiology for reduced ejection fraction and CCM device consideration. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
0418T | Interrogation of implantable cardiac contractility modulation (CCM) system; in-person evaluation including connection/disconnection and analysis with report | Primary code for the in-person CCM system interrogation encounter. |
93299 | Unlisted cardiovascular service or procedure | May be used for atypical device programming or services not described by existing CPT codes when billed with appropriate documentation. |
93270 | Interrogation device evaluation (in-person) with programming of pacemaker, defibrillator, or leadless device; analysis and report | Related interrogation and programming service for other cardiac implantable electronic devices; performed when patients have multiple device types or comparative device evaluations. |
93620 | Intracardiac electrophysiologic study with induction of arrhythmia when performed (diagnostic) | May be part of a broader electrophysiology workup when CCM interrogation reveals arrhythmia concerns requiring electrophysiology testing. |
33206 | Insertion of transvenous single lead pacemaker system; atrial | Representative of lead/device implantation procedures that may precede CCM implantation or follow-up in workflows involving lead revision. |
Note: If additional related CPT codes are required for billing (for example, remote monitoring or separate device implantation/revision), they should be selected per payer guidelines and documented in the medical record.