An implantable loop recorder (ILR) is one of the most valuable diagnostic tools available to evaluate intermittent, unexplained arrhythmias. ILRs continuously monitor the heart’s rhythm for months to years and automatically record events such as pauses, atrial fibrillation, tachyarrhythmias, or bradyarrhythmias.
When a patient returns to the office for an in-person interrogation of their ILR, physicians and clinics use CPT 93286 to bill the service. This code represents the combined technical and professional work of retrieving data from the loop recorder, reviewing all stored events, and creating a complete interpretation report. Strengthen your remote device monitoring workflows using our detailed CPT 93272 Pacemaker & ICD Remote Monitoring Billing Guide covering documentation, technical components, and payer rules.
This guide covers everything your practice needs to know about using CPT 93286 accurately, including documentation, payer rules, prior authorization, and how to avoid denials.
What Is CPT 93286?
Official CPT definition:
“Interrogation device evaluation (in person) with analysis, review, and report by a physician or qualified health care professional of an implantable loop recorder system.”
In plain language:
CPT 93286 = An in-person ILR check where you download data + review it + interpret it, + document a final report.
This code is used for all major loop recorder brands, including:
- Medtronic Reveal LINQ™
- Abbott Confirm Rx™
- Biotronik BioMonitor™
- Boston Scientific LUX-Dx™
What CPT 93286 Includes
To correctly bill 93286, you must perform ALL three components:
1. Technical Component
Performed by staff:
- Connecting the programmer or the wand
- Retrieving stored rhythm data
- Reviewing battery and device function
- Downloading event records
- Ensuring data quality
2. Data Analysis
The system and staff must evaluate:
- Arrhythmia episodes (AF, SVT, VT)
- Pause episodes
- Ectopy
- Tachycardia/bradycardia events
- Patient-triggered recordings
- Automatic detections
- Symptom correlation
3. Physician Interpretation + Report
A qualified provider must:
- Interpret findings
- Evaluate clinical significance
- Correlate symptoms with reports
- Assess device status
- Provide recommendations
- Sign the final report
If all three steps are not completed, 93286 cannot be billed.
When to Use CPT 93286
Use 93286 for:
- In-office ILR interrogation
- Routine check-ups (battery, sensing, detections)
- Symptom-driven evaluations (palpitations, dizziness, skipping beats)
- Post-alert interrogation (if an abnormal event was detected)
- Rechecks after cardiac events
- Post-implant follow-up
The service must be performed in person. Remote checks use different codes (typically 93298).
Ensure proper billing for in-clinic device evaluations using our CPT 93287 ICD/CRT-D In-Person Interrogation Billing Guide built to help cardiology teams maintain clean claims.
When NOT to Use CPT 93286
Do not use 93286 when:
❌ The interrogation was remote
Remote ILR checks use 93298 (not 93286).
❌ The device was not interrogated
If the device wasn’t actually connected and analyzed, → not billable.
❌ You only performed technical work
Then use technical-only code 93285.
❌ You only interpret/send a report
Then use 93285 or remote codes depending on the situation.
❌ The device is not a loop recorder
Pacemakers and ICDs use different codes.
Documentation Requirements for CPT 93286
To avoid denials, include the following:
1. Reason for interrogation (medical necessity)
Examples:
- Syncope
- Palpitations
- “Device-generated alert”
- “Patient reports dizziness.”
2. Loop recorder details
- ILR brand/model
- Implant date
- Battery status
3. Data interrogation details
- Date/time of interrogation
- Device connection method
- Stored episodes reviewed
- Leadless sensing evaluation
4. Clinical interpretation
Must include analysis of:
- AF burden
- Pause episodes
- SVT/VT events
- Bradycardia events
- Ectopic activity
- Symptom correlation
5. Impression + recommendations
- Final diagnosis
- Management plan
- Follow-up recommendations
6. Provider signature
Required by Medicare & most commercial payers.
Does CPT 93286 Require Prior Authorization?
Medicare
- PA not required
- Must be medically necessary
Medicaid
- Usually no PA
- State-dependent
Commercial Plans
- Typically NO PA
- But may require it if:
- Frequent checks (multiple in <30 days)
- Patient is newly implanted
- Complex arrhythmia history
How Often Can You Bill CPT 93286?
Most payers allow:
- Every 30 days if medically needed
- Every 90 days for routine ILR checks
Event-triggered or symptom-driven interrogations may be billable separately (depending on plan). Master documentation and payer rules with our comprehensive CPT 93458 Left Heart Catheterization & Coronary Angiography Billing Guide optimized for interventional cardiology practices.
Common Denials & How to Prevent Them
❌ 1. Missing provider interpretation
Solution:
- Add signed report
❌ 2. Not documenting medical necessity
Add symptom + reason for check.
❌ 3. Wrong code (remote check billed as 93286)
Remote = 93298.
❌ 4. Interrogation done, but no data downloaded
Document technical success.
❌ 5. Billed too frequently
Follow payer frequency guidelines.
ICD-10 Codes Frequently Used With 93286
- R00.2 – Palpitations
- R42 – Dizziness
- R55 – Syncope
- I48.91 – Atrial fibrillation
- I47.1 – SVT
- I49.5 – Sick sinus syndrome
- I47.2 – Ventricular tachycardia
- I49.3 – PVCs
- Z45.09 – Encounter for loop recorder check
- Z86.73 – History of TIA
- Z86.74 – History of sudden cardiac arrest
Final Thoughts
CPT 93286 is a key code for cardiology practices and electrophysiology clinics performing in-person loop recorder evaluations. Proper documentation, correct technical procedures, and timely reporting are essential for clean claims. Stay compliant with complex procedural rules using our CPT 93460 Right & Left Heart Catheterization Billing Guide covering documentation, contrast use, and NCCI bundling.
If your clinic needs help managing ILR billing, follow-up workflows, or payer compliance, Global Tech Billing LLC provides specialized cardiology billing expertise to ensure accurate reimbursement.
Frequently Asked Questions (FAQ)
1. Can NPs or PAs bill 93286?
Yes — if allowed by payer rules.
2. How long does an ILR interrogation take?
Usually 10–20 minutes.
3. Do you need a separate report?
Yes — required for reimbursement.
4. What if the ILR battery is depleted?
Still billable if an interrogation attempt is made and documented.
5. Can 93286 be billed alongside an E/M visit?
Yes — if the E/M is separately identifiable (modifier 25 required).
Reduce audit risk and correctly bill emergent PCI cases using our CPT 92941 Acute MI PCI Billing Guide complete with coding tips, modifier rules, and clinical documentation requirements.
