Cardiology Coding Alert
Determine Coding for ICD Cardioversion Encounter
Question: A patient had cardioversion by his ICD followed by reprogramming. Should I report 92961 and 93283?
Codify Subscriber
Answer: You should not report 92961 (Cardioversion, elective, electrical conversion of arrhythmia; internal [separate procedure]) for ICD cardioversion with reprogramming code 93283 (Programming device evaluation [in person] with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; dual lead implantable cardioverter-defibrillator system).
An instruction with 92961 tells you not to report that code with 93283, among others: “Do not report 92961 in conjunction with 93282-93284, 93287, 93289, 93295, 93296, 93618-93624, 93631, 93640-93642, 93650, 93653-93657, 93662.”
Perhaps more important is that 92961 represents a more involved service than ICD cardioversion, according to CPT® Assistant (November 2000): “This procedure is most commonly used to convert atrial fibrillation to normal sinus rhythm when external cardioversion is unsuccessful. Internal cardioversion requires vascular access, placement of catheters into the heart under fluoroscopic guidance, and a much greater knowledge of electrophysiology procedures.”
Experts advise that you may report 93799 (Unlisted cardiovascular service or procedure) to represent internal cardioversion performed using a patient’s existing generator (without paddles) and existing leads (without additional electrocatheters positioned in the heart)
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