Cardiology Coding Alert

Question: What is the appropriate code for cardiac ablation when performed using radiofrequency?

New York Subscriber

Answer: Whether performed by radiofrequency, cryotherapy, or ultrasound, your code options remain the same:

• 93650 -- Intracardiac catheter ablation of atrioventricular node function, atrioventricular conduction for creation of complete heart block, with or without temporary pacemaker placement commonly referred to as AV node ablation
• 93651 -- Intracardiac catheter ablation of arrhythmogenic focus; for treatment of supraventricular tachycardia by ablation of fast or slow atrioventricular  pathways, accessory atrioventricular connections or other atrial foci, singly or in combination relevant terms include pulmonary vein ablation and treatment of atrial fib (atrial fibrillation), atrial flutter, supraventricular tachycardia (SVT), paroxysmal SVT (PSVT), atrial tachy (atrial  achycardia), accessory pathway, AV node reentry, or WPW (Wolff-Parkinson-White)
• 93652 -- ... for treatment of ventricular tachycardia.commonly referred to as VT ablation.

Watch for: You may be able to report additional codes depending on the other services performed and documented on the same date. For example, CPT guidelines for "Intracardiac Electrophysiological Procedures/Studies" state, "Electrophysiology study(ies), mapping and ablation represent distinctly different procedures, requiring individual reporting whether performed on the same or subsequent dates."

You will encounter Correct Coding Initiative (CCI) edits when the physician does not perform a complete diagnostic study (93619-93623), and you report individual components of an electrophysiologic study in addition to the mapping and ablation procedure during the same session. Some of the edits have a modifier indicator of 1, meaning you may use a modifier to override the edit when appropriate. Others have a modifier indicator of 0, so you may not override the edit.

-- Coding expertise for this issue provided by Christina Neighbors, MA, CPC, CCC, ACS-CA, charge capture reconciliation specialist and coder at St. Joseph Heart & Vascular Center in Tacoma, Wash., and member of the AAPC'sCertified Cardiology Coder steering committee.