Summary & Overview
CPT 0576T: In‑Person ICD Interrogation and Evaluation
CPT code 0576T designates an in‑person interrogation and evaluation of an implantable cardioverter‑defibrillator (ICD) system performed by an OQHCP or physician, including connecting/disconnecting device components, recording interrogation results, and preparing an analysis and report. Nationally, this code captures a distinct clinical interaction focused on device function, programming review, and documentation that supports ongoing device management and patient safety. Payers commonly involved in coverage and payment policies for this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the service elements represented by the code, comparisons of how major payers cover and reimburse this type of ICD interrogation encounter, and clinical context about where and how the service is typically delivered. The publication also summarizes benchmarks for reporting frequency, documentation expectations, and any notable policy updates affecting device interrogation services. Data not available in the input is noted where payer‑specific rates, associated taxonomies, ICD‑10 pairings, and related billing codes would otherwise be presented.
Billing Code Overview
CPT code 0576T describes an in‑person interrogation and evaluation of an implantable cardioverter‑defibrillator (ICD) system by an OQHCP or physician. The service includes connecting and disconnecting device components, recording interrogation results, and performing analysis, review, and a report of findings and the programmed device settings. This code is reported for each patient encounter to interrogate the ICD system.
Service type: Device interrogation and evaluation
Typical site of service: Hospital outpatient department, ambulatory surgical center, or specialized cardiac device clinic where in‑person device interrogation and evaluation are performed.
Clinical & Coding Specifications
Clinical Context
A 68-year-old male with ischemic cardiomyopathy and a previously implanted single- or dual-lead implantable cardioverter–defibrillator (ICD) presents to the cardiac device clinic for routine device interrogation after remote alerting suggested a high-voltage therapy charge. The patient arrives for an in-person visit where an electrophysiology-trained physician or Other Qualified Healthcare Professional (OQHCP) performs an interrogation of the ICD system. The workflow includes obtaining history and symptoms, reviewing device logs and arrhythmia episodes, connecting the programmer to the ICD, recording sensing, lead impedances, battery status, and therapies delivered, adjusting programmed settings if indicated, documenting findings, and disconnecting the programmer. A written or electronic report of analysis and any reprogramming actions is completed and placed in the medical record. Typical sites of service are the hospital outpatient clinic, ambulatory surgery center device clinic, or office-based cardiac device clinic. The scenario commonly follows alerts for ventricular tachycardia/fibrillation, syncope, inappropriate shocks, routine surveillance, or pre/post procedural checks surrounding generator replacement or lead revision.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the physician professional component separate from the technical aspects if applicable in split services. |
52 | Reduced services | Use when the interrogation or evaluation is substantially reduced compared with full service. |
53 | Discontinued procedure | Use when the interrogation is started but discontinued for patient safety or other valid clinical reasons. |
62 | Two surgeons | Use when two physicians of equal specialty are required and both actively participate in the evaluation related to device management. |
80 | Assistant surgeon | Use when an assistant surgeon is required during a concurrent procedure related to device revision or extraction. |
82 | Assistant surgeon (when qualified assistant unavailable) | Use when a qualified assistant is unavailable but an assistant is still used during a related operative episode. |
AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for Medicare | Use when a PA/NP/CNS furnishes the professional component under Medicare rules and billing requires AS. |
QK | Medical direction of two, three, or four individuals | Use when the reporting physician medically directs qualified health professionals during multiple concurrent sessions of device interrogations. |
QX | Qualified nonphysician practitioner with modifier QK | Use when a qualified nonphysician provides services under medical direction identified by QK. |
QY | Medical direction of one qualified nonphysician | Use when the physician directs a single nonphysician performing the interrogation. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207RH0000X | Cardiac Electrophysiology | Electrophysiologists perform device interrogations and programming. |
| 207RC0000X | Cardiovascular Disease | General cardiologists commonly manage ICD follow-up and routine interrogations. |
| 363LF0000X | Nurse Practitioner (Cardiology) | NPs in device clinics frequently perform interrogations under physician oversight. |
| 363LP0200X | Physician Assistant (Cardiology) | PAs in cardiology/device clinics perform evaluations and device interrogations under supervision. |
| 207Q00000X | Internal Medicine | Hospitalists or internists may be involved in inpatient device checks or pre/post procedural evaluations. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
I49.01 | Ventricular fibrillation | ICD interrogations are performed to evaluate shocks or arrhythmic events recorded by the device. |
I49.02 | Ventricular tachycardia | Relevant when the ICD records VT episodes and therapy delivery that require analysis. |
I46.9 | Cardiac arrest, cause unspecified | Post-arrest device interrogation assesses therapies delivered and device function. |
I50.22 | Chronic systolic (congestive) heart failure | Patients with reduced ejection fraction commonly have ICDs for primary or secondary prevention and require routine interrogation. |
Z45.01 | Encounter for adjustment and management of implanted cardiac device | Specifically indicates follow-up and programming/management of an implanted ICD. |
T82.110A | Breakdown (mechanical) of cardiac defibrillator, initial encounter | Used when device malfunction or lead issues are suspected and interrogation is performed to diagnose the problem. |
R55 | Syncope and collapse | Evaluation after syncope often includes ICD interrogation to determine whether arrhythmia or device therapy was involved. |
Z45.810 | Encounter for adjustment and management of implanted electronic cardiac device | Another code indicating device follow-up and management relevant to interrogation visits. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
93288 | Interrogation device evaluation (in-person), program/analysis with reprogramming when performed; includes connective/disconnect and report | Often performed for pacemakers and ICDs; 0576T is specific to ICD system interrogation by OQHCP or physician and may be reported per encounter when this is the service rendered. |
93290 | Programming device evaluation (in-person) with iterative reprogramming, including connective/disconnect and analysis | Used when more extensive programming and iterative testing are performed beyond a standard interrogation visit and may accompany or follow an ICD interrogation. |
93799 | Unlisted cardiovascular service or procedure | Used when a specific device-related service is not described by existing codes; occasionally used for atypical device management not captured by 0576T. |
33207 | Insertion of transvenous single lead implantable defibrillator or cardiac resynchronization ICD system | Related as an initial implantation procedure preceding future interrogations and follow-up visits coded with 0576T. |
33249 | Revision or replacement of pacemaker or ICD lead, single or multiple leads | Performed when interrogation identifies lead malfunction requiring revision; interrogation is part of the pre- and post-procedure evaluation. |