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LATITUDE® Patient Management

Illinois Medicare Reimbursement Fact Sheet

Last updated: June 2007

This fact sheet provides coverage and coding guidance for Wisconsin Physicians Service (WPS) providers in Illinois.

Coding and Payment

On June 9, 2006, the Centers for Medicare and Medicaid Services (CMS) issued a program transmittal providing direction for its carriers regarding coding for remote monitoring. The program transmittal standardizes codes to be used for remote monitoring of ICDs and Pacemakers. Effective July 10, 2006, carriers shall pay for the electronic analysis of an implanted cardiac device using remotely obtained data with CPT codes 93741, 93743 depending on the type of cardiac device implanted in the patient.

The Medicare physician fee schedule payment rates associated with these codes in Illinois are provided below.

Note: This state has multiple localities.

If you don't recognize your locality in the table below, enter your ZIP code:




CPT Code Description 2007 Medicare Physician
Fee Schedule Payment²
93741 Electronic analysis of pacing cardioverter-defibrillator (includes interrogation, evaluation of pulse generator status, evaluation of programmable parameters at rest and during activity where applicable, using electrocardiographic recording and interpretation of recordings at rest and during exercise, analysis of event markers and device response); single-chamber or wearable cardioverter-defibrillator system, without reprogramming

Locality 12 (East St. Louis):
$25.77 (technical)
$41.34 (professional)
$67.10 (global)

Locality 15 (Suburban Chicago):
$29.98 (technical)
$44.00 (professional)
$73.98 (global)

Locality 16 (Chicago):
$30.57 (technical)
$44.57 (professional)
$75.14 (global)

Locality 99 (Rest of IL):
$23.31 (technical)
$39.86 (professional)
$63.17 (global)

93743 dual-chamber, without reprogramming

Locality 12 (East St. Louis):
$27.90 (technical)
$52.74 (professional)
$80.64 (global)

Locality 15 (Suburban Chicago):
$32.52 (technical)
$56.21 (professional)
$88.73 (global)

Locality 16 (Chicago):
$33.14 (technical)
$56.88 (professional)
$90.02 (global)

Locality 99 (Rest of IL):
$25.30 (technical)
$53.02 (professional)
$76.31 (global)

LATITUDE Alert Coding and Payment

LATITUDE Patient Management system remote follow-ups, just like in-office follow-ups, must meet the definition of Medical Necessity and should be documented. Providers can bill Clinical Event Notifications (alerts) and Patient Initiated Interrogations (PIIs), provided the Clinical Event Notifications (alerts) or the PII make it medically necessary for a physician to perform a complete electronic analysis as described by either of these codes, 93741 or 93743. Like in-office interrogations, each element in the code descriptor must be performed and/or documented in order to bill the service. When it is not medically necessary to obtain each element, it may be appropriate to bill the service with the -52 (Reduced Services) modifier appended to the code.

93741 Electronic analysis of pacing cardioverter-defibrillator (includes interrogation, evaluation of pulse generator status, evaluation of programmable parameters at rest and during activity, where applicable, using electrocardiographic recording and interpretation of recordings at rest and during exercise, analysis of event markers and device response); single chamber or wearable cardioverter-defibrillator system, without reprogramming.

93743 Electronic analysis of pacing cardioverter-defibrillator (includes interrogation, evaluation of pulse generator status, evaluation of programmable parameters at rest and during activity where applicable, using electrocardiographic recording and interpretation of recordings at rest and during exercise, analysis of event markers and device response); dual chamber, without reprogramming.

Coverage

Wisconsin Physician Services (WPS) has issued a local coverage determination (LCD) for Cardiac Rhythm Device Evaluation.³ The LCD includes coverage for ICD remote monitoring services, like those provided by LATITUDE® Patient Management.

Read the local coverage determination on website.

Local Medicare Carrier

The local Medicare Part B carrier in Illinois is Wisconsin Physicians Service. To seek additional coverage, coding, or payment clarification for LATITUDE Patient Management remote monitoring services, contact WPS.

Wisconsin Physicians Service
28300 Northwestern Hwy, Suite 200
Southfield, MI 48075

Telephone: 248.395.7702
Website: www.wpsmedicare.com
Medical director: Michael Rosenberg, MD

Additional Information

Call 1-800-CARDIAC, and ask to be transferred to the CRM reimbursement call center.

Back to LATITUDE Reimbursement Map


  1. American Medical Association. Coding communication: electronic analysis of implantable cardioverter-defibrillators (ICDs) using data remotely obtained. In: CPT Assistant. September 2005. 15:9:1.
  2. Centers for Medicare and Medicaid Services. Physician Fee Schedule Carrier-Specific Files 2007. Available at: http://www.cms.hhs.gov/apps/pfslookup/. Accessed January 2007.
  3. Wisconsin Physician Services (WPS). Local coverage determination: Cardiac rhythm device evaluation Available at: http://www.wpsmedicare.com/provider/provhome.shtml. Accessed May 2007

Current Procedural Terminology (CPT) is copyright 2006 American Medical Association (AMA). All Rights Reserved. No fee schedules, basic units, relative values, or related listings are included in CPT. The AMA assumes no liability for the data contained herein. Applicable FARS/DFARS restrictions apply to government use. CPT is a registered trademark of the American Medical Association.

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Disclaimer: The information provided on this website was obtained from third-party sources and is subject to change without notice, as a result of changes in reimbursement laws, regulations, rules and policies. All content on this website is informational only, general in nature and does not cover all situations or all payers’ rules and policies. This content is not intended to instruct medical providers on how to use or bill for healthcare procedures including new technologies outside of Medicare national guidelines. A determination of medical necessity is a prerequisite that Boston Scientific assumes will have been made prior to assigning codes or requesting payments. Medical providers should consult with appropriate payers, including Medicare fiscal intermediaries and carriers, for specific information on proper coding, billing and payment levels for healthcare procedures.

This website represents no promise or guarantee by Boston Scientific regarding coverage, coding, billing and payment levels. Boston Scientific specifically disclaims liability or responsibility for the results or consequences of any actions taken in reliance on information on this website.

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