Summary & Overview
CPT 0930T: Electrophysiologic Evaluation During Cardiac Contractility Modulation–Defibrillator Implantation
CPT code 0930T identifies an intraoperative electrophysiologic evaluation performed during initial implantation or replacement of a cardiac contractility modulation–defibrillation system. The procedure assesses lead function and pulse generator performance through defibrillation-threshold testing, arrhythmia induction, and verification of sensing and therapy for arrhythmia termination. This service is clinically significant because it ensures device efficacy and patient safety at the time of implantation, with implications for perioperative risk management and subsequent device performance.
Key payers included in assessments and coverage discussions are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for the code, typical sites of service, and the common modifiers associated with reporting. The publication summarizes national coverage considerations and coding practice benchmarks relevant to electrophysiologic testing during device implantation, and highlights areas where policy updates or payer-specific requirements commonly arise. Clinical teams, coding professionals, and policy analysts will gain a practical understanding of the service represented by 0930T, how it fits into procedural workflows for cardiac device implantation, and the payer landscape that most frequently adjudicates claims for this intraoperative testing.
Billing Code Overview
CPT code 0930T describes an electrophysiologic evaluation of the leads of a cardiac contractility modulation–defibrillation system performed at the time of initial implantation or replacement. The service includes defibrillation-threshold evaluation, induction of arrhythmia, and assessment of sensing and therapy for arrhythmia termination, and also encompasses testing of the pulse generator.
Service Type: Cardiac device implantation and electrophysiologic testing
Typical Site of Service: Hospital operating room or cardiac catheterization/electrophysiology laboratory
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with symptomatic heart failure and reduced ejection fraction undergoes implantation of a cardiac contractility modulation–defibrillation system. The implanting electrophysiologist performs intraoperative electrophysiologic evaluation of the system leads and pulse generator function during the initial device implantation or at replacement. The clinical workflow includes device placement in the electrophysiology lab or hybrid operating room under conscious sedation or general anesthesia, lead positioning with fluoroscopic guidance, intraoperative testing of sensing and pacing thresholds, induction of arrhythmia to confirm therapy delivery, defibrillation-threshold (DFT) testing as indicated, and documentation of lead integrity and device telemetry. Post-procedure monitoring occurs in a recovery area or cardiac observation unit with device interrogation and programming prior to discharge. Typical site of service is an inpatient or outpatient electrophysiology laboratory or an operating room specializing in cardiac device implantation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work required to perform the procedure is substantially greater than typically required. |
26 | Professional component | Use when reporting only the physician’s professional component separate from the technical component. |
51 | Multiple procedures | Use when multiple distinct procedures are performed during the same session and payer requires reporting of a secondary procedure. |
52 | Reduced services | Use when the procedure is partially reduced or not completed as described. |
53 | Discontinued procedure | Use when the procedure is started but discontinued due to extenuating circumstances. |
80 | Assistant surgeon | Use when a surgical assistant (not as an assistant at surgery requirement) provides assistance. |
82 | Assistant surgeon (when qualified resident not available) | Use when a qualified resident is not available and an assistant surgeon is required. |
AS | Ambulatory surgery center facility | Use to indicate services furnished in an Ambulatory Surgical Center setting. |
TC | Technical component | Use when reporting only the technical component of the service (equipment, supplies, technical staff). |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207RH0000X | Cardiology (Interventional) | Electrophysiologists and cardiac interventional cardiologists who implant and test device systems. |
| 2084P0807X | Cardiac Electrophysiology | Specialists who perform device implantation and intraoperative electrophysiologic testing. |
| 207RP1001X | Cardiovascular Disease | General cardiologists involved in pre- and post-implant management and device interrogation. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
I50.22 | Chronic systolic (congestive) heart failure | Common indication for therapies that improve contractility; patients may receive contractility modulation devices. |
I50.32 | Chronic diastolic (congestive) heart failure | Heart failure with preserved ejection fraction patients considered in device therapy evaluation. |
I50.9 | Heart failure, unspecified | General designation for heart failure when specific type is not detailed; often present in device candidates. |
I49.01 | Ventricular fibrillation | Represents malignant ventricular arrhythmia that may necessitate defibrillation-capable devices and intraoperative testing. |
I49.9 | Cardiac arrhythmia, unspecified | Arrhythmias that require evaluation of sensing and therapy delivery by implantable devices. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
33249 | Insertion or replacement of implantable cardioverter‑defibrillator pulse generator, with lead revision when performed | May be performed in the same session when generator replacement or revision is needed; addresses generator implantation distinct from electrophysiologic lead testing. |
33263 | Insertion of lead(s) for cardiac resynchronization therapy, with or without device generator | Performed when CRT leads are placed; electrophysiologic evaluation of leads may occur concurrently. |
93620 | Comprehensive electrophysiologic evaluation including insertion and repositioning of catheter(s) and induction of arrhythmia, with or without pharmacologic agents | Shares components of arrhythmia induction and electrophysiologic testing; complements device-specific lead testing when arrhythmia induction is required. |
93270 | Interrogation device evaluation (e.g., pacemaker, implantable defibrillator), including analysis, review, and report, performed in a facility | Used for post-implant device interrogation and follow-up programming after initial intraoperative testing. |
93040 | Programming device evaluation (e.g., pacemaker, implantable defibrillator) with analysis and report | Performed during or after implantation for device reprogramming and verification of therapy parameters. |