Summary & Overview
CPT 0575T: ICD Programming Evaluation and Device Reprogramming
CPT code 0575T represents an in-person evaluation and iterative reprogramming of an already implanted cardioverter–defibrillator (ICD) system performed by an OQHCP or physician. The code encompasses the hands-on assessment, repeated adjustments of device components, and the clinician's analysis and report of the selected permanent programmed values. This service supports optimization of ICD function and patient safety by tailoring device parameters to individual clinical needs.
Key national payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise account of how CPT code 0575T is defined clinically and operationally, plus what to expect in typical sites of service such as hospital-based device clinics and outpatient cardiology settings. The publication presents benchmarks and policy-relevant context for coverage and billing practices, outlines common billing considerations, and summarizes clinical context that drives utilization of device programming services. Specific payer policy details, coding variants, and related claims-handling practices are included where available.
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Billing Code Overview
CPT code 0575T describes an in-person clinical service in which an OQHCP or physician evaluates an already implanted cardioverter–defibrillator (ICD) system and repeatedly adjusts the device's programmed settings to determine and select the optimal permanent programmed values. The service includes the clinician's analysis, review, and a report of findings and the final programmed settings.
-
Service type: Device programming and reprogramming evaluation with iterative adjustments
-
Typical site of service: Hospital inpatient or outpatient cardiology clinic, device clinic, or other facility where implanted cardiac devices are managed
Clinical & Coding Specifications
Clinical Context
A 68-year-old male with ischemic cardiomyopathy and a previously implanted transvenous implantable cardioverter–defibrillator (ICD) presents for an in-person device evaluation. The patient reports occasional palpitations and one suspected shock event. The device clinic visit is scheduled as a focused programming session to interrogate the ICD, review arrhythmia logs, assess lead integrity and sensing thresholds, and repeatedly adjust therapy and detection parameters to determine optimal permanent programmed values. The office or outpatient clinic workflow includes device interrogation using the manufacturer programmer, analysis of stored electrograms, reprogramming of tachycardia detection zones, adjusting pacing and shock energies, documention of changes and rationale, and communication of findings in a written report placed in the medical record. If intra-procedural issues arise (for example, lead malfunction, recurrent inappropriate therapies, or symptoms during reprogramming), additional interventions or inpatient monitoring may follow per clinical decision-making.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the physician's professional service separate from a facility or technical component. |
52 |