Cardiology Coding Alert

Reader Questions:

Cardiologist Performed Both PVI and CTI Ablations? Do This

Question: If the cardiologist performed a pulmonary vein isolation (PVI) ablation, and she also performed an empiric CTI ablation, can I separately report the CTI ablation?

North Carolina Subscriber

Answer: We do not recommend coding an additional ablation for empiric CTI ablation. If after performing the PVI 93656 (Comprehensive electrophysiologic evaluation including transseptal catheterizations, insertion and repositioning of multiple electrode catheters with induction or attempted induction of an arrhythmia including left or right atrial pacing/ recording when necessary, right ventricular pacing/recording when necessary, and His bundle recording when necessary with intracardiac catheter ablation of atrial fibrillation by pulmonary vein isolation) the provider performs additional lesions for remaining atrial fibrillation, you can bill code +93657 (Additional linear or focal intracardiac catheter ablation of the left or right atrium for treatment of atrial fibrillation remaining after completion of pulmonary vein isolation (List separately in addition to code for primary procedure) or for atrial arrhythmia, you can bill code +93655 (Intracardiac catheter ablation of a discrete mechanism of arrhythmia which is distinct from the primary ablated mechanism, including repeat diagnostic maneuvers, to treat a spontaneous or induced arrhythmia (List separately in addition to code for primary procedure).