Cardiology Coding Alert

Question: My cardiologist saw a patient with a single-chamber internal cardioverter-defibrillator (ICD) placed two months ago. Now the patient is undergoing an analysis of the ICD (V53.32) as an outpatient, including threshold testing, and no reprogramming is required. How should I code this?

Virginia Subscriber

Answer: You should report 93641 (Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation [induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination] at time of initial implantation or replacement; with testing of single or dual chamber pacing cardioverter-defibrillator pulse generator) because your question includes "threshold testing." Code 93641 includes arrhythmia induction.

Keep in mind: The 90-day global surgical fee does not include the ICD evaluation within 90 days of the device implantation. Therefore, you should report ICD analysis services separately during the 90-day global.