Billing and Coding: Surveillance of Implantable or Wearable Cardioverter Defibrillators (ICDs): Office, Hospital, Web, or Non-Web Based

Interrogation and surveillance of implantable/wearable ICDs (in-person, remote, or web-based) are covered when medically necessary and documented, including provider assessment, history, test results, device identification, and signed reports. Remote interrogations are limited to once every 90 calendar days and in-person monitoring visits without symptoms (or device discharge Z95.810) are limited to once every three months; ABN and modifier rules (GA/GX/GY/GZ) and specific documentation (eg, Form CMS-R-131, occurrence code 32) must be followed for billing and potential denials.

"Interrogation (in-person, remote/web-based, or device transmission) of implantable or wearable cardioverter defibrillators (ICDs) is covered when medically necessary and supported by documentation ..."

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