Cardiology Coding Alert

Question: Both 93619 and 93620 refer to EP evaluations with attempted induction. Which should we use if the physician tries to induce arrhythmia but fails?

Oklahoma Subscriber

Answer: The appropriate code for a complete electrophysiologic (EP) evaluation in which the physician tries to induce arrhythmia but fails is 93620 (Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with right atrial pacing and recording, right ventricular pacing and recording, His bundle recording).

The definition of 93620 specifies it is appropriate "with induction or attempted induction of arrhythmia."

Note how the definition differs from 93619 (Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, His bundle recording, including insertion and repositioning of multiple electrode catheters, without induction or attempted induction of arrhythmia).

Key: Code 93619 specifies "without induction or attempted induction." To correctly grasp 93619, apply the term "without" to the entire phrase so that you see it means "without attempted induction."

In other words: If the physician makes any attempt at induction (successful or not), use 93620. If the physician makes no attempt at induction, use 93619.

Final note: If you're reporting only the professional component of the evaluation, remember to append modifier 26 (Professional component) to 93619 and 93620.