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CPT 93272: Complete Billing Guide for Pacemaker/ICD Remote Monitoring (Global Service)

Remote monitoring has become a standard component of modern cardiac care, especially for patients with implanted pacemakers and implantable cardioverter-defibrillators (ICDs). These devices require ongoing evaluation to ensure battery health, lead integrity, arrhythmia detection, and proper device function.

To support this, the CPT code 93272 is used to bill the global service of remote monitoring, which includes both the technical and professional components. Improve accuracy and avoid interrogation denials with our CPT 93286 Loop Recorder In-Person Interrogation Billing Guide including coding, device checks, and setup requirements.

This comprehensive guide explains everything you need to know about CPT 93272 — when to use it, what it includes, documentation requirements, payer rules, and how to avoid the most common denials.

What Is CPT 93272?

Official CPT definition:

“Remote monitoring of a pacemaker system or implantable defibrillator system via interrogation device, physician, or other qualified health care professional review, analysis, and report; global service.”

In simple terms:

CPT 93272 = the full (global) service for remote monitoring of a pacemaker or ICD.

It includes:

  • Data transmission
  • Technical activities
  • Device interrogation
  • Physician analysis
  • Final report

If your clinic both receives the remote transmission and interprets the data, this is the correct code.

When to Use CPT 93272

Use CPT 93272 when:

  • A pacemaker or ICD sends remote transmission data
  • Your clinic receives the data through a home transmitter or cloud-based system
  • Your staff performs the technical setup/verification
  • A physician or qualified provider reviews, analyzes, and interprets the data
  • A final report is generated and signed
  • The service meets payer time-frequency rules

Typical clinical reasons include:

  • Scheduled routine device checks
  • Checking lead impedances
  • Battery depletion tracking
  • Detecting arrhythmias (e.g., AF, NSVT)
  • Evaluating device alerts
  • Monitoring shock episodes
  • Reviewing therapy delivery
  • Confirming proper sensing/pacing thresholds

Remote monitoring is now required by most device manufacturers and is considered standard follow-up care. 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.

What CPT 93272 Includes

To bill CPT 93272 correctly, the following three elements must be completed:

1. Technical Component

Performed by clinical staff or the device system:

  • Data retrieval
  • Connection to the remote monitoring system
  • Receiving transmissions
  • Checking lead status
  • Verifying transmission quality
  • Documenting technical details

2. Device Analysis

Includes:

  • Intrinsic rhythm evaluation
  • Pacing percentages
  • Battery voltage
  • Impedance trends
  • Arrhythmia detection
  • Therapy trigger events
  • Delivery of shocks or ATP

Technical staff may assist, but a qualified provider must review the final data.

3. Provider Interpretation + Final Report

A cardiologist, electrophysiologist, or qualified provider must:

  • Review pacing thresholds
  • Interpret sensing/lead parameters
  • Assess battery life
  • Evaluate arrhythmia episodes
  • Review alerts or device abnormalities
  • Provide clinical recommendations
  • Sign the final report

This is what justifies billing the global code rather than interpretation-only (93271) or technical-only (93270). Master documentation and payer rules with our comprehensive CPT 93458 Left Heart Catheterization & Coronary Angiography Billing Guide optimized for interventional cardiology practices.

Difference Between 93270, 93271, and 93272

CodeComponentWho Bills It

93270 Technical only Clinic/device center

93271 Interpretation only Physician

93272 Global (technical + interpretation) Clinic providing full service

Use 93272 when BOTH components are provided by your practice.

Documentation Requirements for CPT 93272

To avoid denials, document:

1. Patient & Device Information

  • Device type: pacemaker or ICD
  • Manufacturer (e.g., Medtronic, Boston Scientific, St. Jude)
  • Model
  • Implant date

2. Transmission Details

Include:

  • Date/time of transmission
  • Successful data download
  • Reason for transmission
    • Routine scheduled check
    • Alert-triggered check
    • Symptom-triggered check
    • Battery alert
    • Lead issue

3. Device Function Analysis

Document:

  • Battery status
  • Lead impedances
  • Sensing and threshold measurements
  • Pacing percentages
  • Arrhythmias detected
  • Any logged events (VT, AF, pauses)

4. Provider Interpretation

The final report must include:

  • Summary of findings
  • Interpretation of device data
  • Clinical significance
  • Recommendations
  • Provider signature + credentials

No signed report = denial.

How Often Can You Bill CPT 93272?

Most payers allow:

  • Every 90 days for routine monitoring
  • So max 4 times per year

However:

  • Some plans allow every 31 days (especially for ICDs)
  • Event-triggered transmissions may count separately depending on payer rules

Always verify frequency limitations with specific payers. Stay compliant with complex procedural rules using our CPT 93460 Right & Left Heart Catheterization Billing Guide covering documentation, contrast use, and NCCI bundling.

Does CPT 93272 Require Prior Authorization?

Medicare

  • No prior authorization required
  • Must meet medical necessity
  • Frequency limits apply

Medicaid

  • Usually, there is no PA, but it varies by state.

Commercial payers

Most do NOT require PA for routine remote device checks.

Rare exceptions include:

  • Strict HMOs
  • Certain Medicare Advantage plans
  • Select Kaiser regions

Overall, CPT 93272 is low-risk for PA requirements.

Typical Reimbursement for CPT 93272

Medicare national average reimbursement:

$30–$45

Commercial payers often reimburse higher, depending on contract rates.

Because the service is low-cost and high-frequency, remote monitoring helps maintain a steady revenue flow for cardiology practices.

Common Denials for CPT 93272 (And How to Fix Them)

❌ 1. Missing physician interpretation

Unsigned or missing reports are the most common reason for denial.

❌ 2. Billed more frequently than allowed

Each payer has time limits.

Fix:

Verify 31-day or 90-day rules before billing.

❌ 3. Billed without device interrogation data

Must include real device data.

❌ 4. Billed when only the technical component was done

If you didn’t interpret → code 93270 only.

❌ 5. Wrong code for the device type

Make sure the device is:

  • Pacemaker
  • ICD

Event monitors, insertable loop recorders, and MCT use different codes.

❌ 6. Device not connected / no data transmitted

If transmission failed, the service is not billable.

Billing Scenarios for CPT 93272

Scenario 1 — Clinic Performs Full Remote Monitoring

Device transmission received

Technical review completed

Physician interprets

Report generated

→ Bill 93272

Scenario 2 — Device Company Does Technical Work

Device rep/device company downloads data

Your physician interprets

Technical copy provided by the manufacturer

→ You bill 93271

→ Device company bills 93270

Scenario 3 — Frequent Alert Transmissions

Some payers treat alert-triggered transmissions separately.

Document:

  • Alert reason
  • Transmission date
  • Provider review

Check payer rules before billing.

ICD-10 Codes Commonly Used With CPT 93272

  • Z95.0 – Cardiac pacemaker in situ
  • Z95.810 – ICD in situ
  • I48.91 – Atrial fibrillation
  • I47.1 – Supraventricular tachycardia
  • I47.2 – Ventricular tachycardia
  • I49.5 – Sick sinus syndrome
  • I50.9 – Heart failure
  • I44.1 – AV block
  • T82.110A – Lead displacement
  • T82.111A – Mechanical device breakdown

Final Thoughts

CPT 93272 is a key code in cardiology and electrophysiology practices that perform remote monitoring of pacemakers and ICDs. Correct coding depends on full completion of the technical and interpretive components, consistent documentation, and adherence to payer frequency rules.

For cardiology practices managing complex device workflows, proper billing ensures accurate reimbursement and compliance. If your practice needs help with remote monitoring, billing, or payer-specific rules, Global Tech Billing LLC provides specialized cardiology billing support.

Frequently Asked Questions (FAQ)

1. Can NPs bill 93272?

Yes — if allowed by the payer and state scope of practice.

2. Does 93272 include event-triggered transmissions?

Yes, if part of the routine monitoring period.

3. Can this be billed monthly?

Some payers allow every 31 days; others every 90 days.

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.

4. What if the patient lives out of state?

Remote monitoring is still billable as long as:

  • Provider is licensed to interpret
  • Billing follows payer rules
  • Documentation is completed

5. Can you bill 93272 for loop recorders?

No — loop recorders use codes 93285–93299.

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