CPT 93292Cardiology

Wcd device interrogate

CPT code 93292 covers the remote interrogation of a wearable cardioverter-defibrillator (WCD), a vest-like device worn by patients at risk of sudden cardiac arrest. The physician reviews data transmitted from the device to assess heart rhythm and device function.

Showing rates for

National Average

Base Medicare rate

$48.84

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

0.43

PE RVU (NF)

1.05

MP RVU

0.03

Total RVU

1.51

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Bill 93292 only once per 30-day monitoring period regardless of number of transmissions received
Impact: Prevents automatic denials for duplicate services; bundling rule limits to one interrogation per month saving appeals time
Document date of data transmission, date of physician review, and specific findings including arrhythmia detection, device alerts, wear time compliance, and any clinical actions taken
Impact: Complete documentation supports medical necessity and reduces audit risk; missing elements account for 35-40% of denials
Verify patient has met minimum wear time requirements (typically 18+ hours/day) as some payers deny claims for non-compliant patients
Impact: Prevents denials based on medical necessity criteria; approximately 15% of WCD patients have compliance issues
Do not bill 93292 on same date as in-person WCD evaluation (93745); use only the face-to-face code when both occur
Impact: Avoids bundling denials; 93292 is for remote-only interrogations between in-person visits
Ensure physician signature and credentials are clearly documented on interpretation report within 30 days of transmission
Impact: Medicare requires signed report within billing period; late signature may result in denial of $48.84 charge
Confirm LCD/NCD coverage criteria for WCD monitoring in your MAC jurisdiction, particularly for non-Medicare patients
Impact: Some commercial payers have restrictive policies or prior authorization requirements that affect the $48.84 reimbursement

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Frequently asked questions

What is CPT code 93292 used for?

CPT 93292 is used for the remote interrogation and physician interpretation of data from a wearable cardioverter-defibrillator (WCD), such as a LifeVest. The code covers review of transmitted device data, ECG recordings, arrhythmia detection, and device function between in-person visits.

How much does Medicare pay for CPT 93292 in 2025?

The 2025 Medicare national average reimbursement for CPT 93292 is $48.84 for both facility and non-facility settings. The code has 1.51 total RVUs (0.43 work RVU, 1.05 PE RVU, 0.03 MP RVU) using the 2025 conversion factor of 32.3465.

How often can CPT 93292 be billed?

CPT 93292 can be billed only once per 30-day monitoring period, regardless of how many data transmissions are received from the wearable defibrillator during that time. Multiple interrogations in the same 30-day period will typically be denied as duplicates.

What documentation is required to bill CPT 93292?

Required documentation includes the date of data transmission, date of physician review, wear time compliance data, review of ECG episodes and arrhythmias, device status, battery function, clinical assessment, any management changes, and a signed physician interpretation report with credentials and date.

Can CPT 93292 be billed with an office visit on the same day?

CPT 93292 should not typically be billed on the same day as an in-person WCD evaluation or E/M service involving device review, as it is intended for remote interrogation between office visits. If both occur on the same date, bill only the face-to-face service unless circumstances clearly support separate, medically necessary services.

What is the difference between CPT 93292 and 93745?

CPT 93292 is for remote interrogation of a wearable cardioverter-defibrillator with data transmitted electronically, while CPT 93745 is for in-person initial setup and patient education for WCD. Code 93292 is used for ongoing remote monitoring, whereas 93745 is typically billed once at WCD initiation.

Do commercial insurance plans cover CPT 93292?

Coverage varies by payer. Most major commercial insurance plans cover CPT 93292 when medically necessary and the patient has an appropriate indication for WCD use, but some require prior authorization or have specific coverage criteria. Verify benefits and medical policy before providing service, as reimbursement rates may differ from the Medicare rate of $48.84.