Summary & Overview
CPT 93146: Implanted Carotid Sinus BAT Device Evaluation and Reprogramming
CPT code 93146 defines the in-person interrogation, evaluation, and reprogramming of an implanted carotid sinus baroreflex activation therapy (BAT) modulation system. This service documents clinician interaction with an implanted neuromodulation device using an external programmer to assess function and adjust therapy settings. Nationally, the code is important for accurate capture of device-management services tied to advanced cardiovascular implantable systems and carries implications for care coordination between cardiology, electrophysiology, and device-support teams.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for device interrogation and reprogramming, typical sites of service, and what to expect in billing documentation when using CPT code 93146. The publication also outlines common benchmarking and policy topics relevant to this service line, including coverage recognition of implanted device management, documentation elements that support medical necessity, and intersections with device follow-up workflows.
This summary is intended to orient clinicians, coding staff, and policy analysts to the primary purpose of CPT code 93146, the clinical setting in which it is used, and the categories of payer coverage that commonly apply.
Billing Code Overview
CPT code 93146 describes an in-person evaluation and check of an implanted carotid sinus baroreflex activation therapy (BAT) modulation system. The service involves communication between an external programmer and the implanted device to review device function and therapy settings, and requires reprogramming of the device to optimize therapy settings.
Service Type: Device interrogation and reprogramming with clinical evaluation
Typical Site of Service: In-person outpatient or office setting where device programming equipment and clinical staff are available, such as a cardiology clinic or electrophysiology lab.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 65-year-old with treatment-resistant hypertension and/or heart failure who previously underwent implantation of a carotid sinus baroreflex activation therapy (BAT) modulation system. The patient presents for an in-person device interrogation visit to review system performance, battery status, sensing, and therapy delivery. The visit includes connection of an external programmer to the implanted pulse generator, review of stored device diagnostics, assessment of symptom response, and adjustment of stimulation parameters. The workflow begins with device interrogation by a trained clinician or device specialist, review of baseline vitals and symptoms, potential reprogramming to optimize therapy settings, verification of capture and patient tolerance of new settings, documentation of settings and device function, and scheduling of follow-up. Typical site of service is an outpatient device clinic, cardiology clinic, electrophysiology lab, or hospital outpatient department where programmer equipment and trained staff are available.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the physician or clinician professional portion of the service separate from facility technical component. |
TC |