Cardiology Coding Alert

Question: Our cardiologist performed the following procedure: Sinus node recovery time was performed using a temporary pacemaker previously inserted into the right ventricle and withdrawn during the procedure to the right atrium. The right atrium was paced at 120 beats per minute for one minute. There were no complications. The temporary pacemaker was removed following the sinus node recovery time with its sheath, and sterile dressing was applied to the wound in the right subclavicular area. The sinus node recovery time equaled 1300 msecs. The corrected sinus node recovery time was 270 msecs. There was normal sinus node function. Should I code this 93610-26? Virginia Subscriber Answer: You should use 93610 (Intra-atrial pacing) appended with modifier -26 (Professional component) in this instance. Because the physician did not place the catheter, you should also add  (Reduced services) to 93610. According to CPT, most electrophysiologic studies attempt to induce arrhythmia(s) from single or multiple sites within the heart by a variety of techniques, including performing pacing at different rates and programmed stimulation, which involves the "introduction of critically timed electrical impulses."

Because you have likely already billed for the temporary pacemaker placement, you should not bill a second time for catheter placement that is already there.