Ask Dr. Z

We are receiving denials for CPT codes 93293, 93294, 93295, and 93296 when they are performed more than once per 90-day period. However, these are being performed because the patient has received an alert or the programing information being reviewed by the provider indicates a potential problem. We are coding these with the ICD-9 code(s) 996.01/996.04 and V45.01 or V45.02 at the recommendation of the cardiac device rep. We have appealed these feeling they are medically necessary, but have been unsuccessful in getting the denials overturned. Do you have any advice or recommendations on proper coding for these instances?