Deny the service b/c the medical records does not support 93294 to be reasonable and necessary. This service initially denied because the number of services performed exceeds Medicare's guidelines. According to the Local Coverage Determination (LCD), Cardiac Rhythm Device Evaluation (L30529) a single chamber pacemaker may be checked twice in the first six months following implant, and then once every 12 months. Dual chamber pacemakers may be checked twice in the first six months then once every six months. The documentation is lacking that the patient presented with compromising symptoms or issues in relation to the pacemaker. For the next level of appeal, please provide detailed office notes/ records including eligible diagnoses or any signs
