Cardiology Coding Alert

Reader Questions:

Determine Role for Chemical Cardioversion Coding

Question: Which code should I report for chemical cardioversion using ibutilide infused over 10 minutes?

South Carolina Subscriber

Answer: According to CPT® Assistant (November 2000), the physician’s coding depends on the services performed. Possibilities include “prolonged services, critical care, evaluation and management services, or codes describing therapeutic or diagnostic infusion or injection procedures.”

Chemical cardioversion typically takes place in an acute care setting to treat patients with recent onset of atrial fibrillation or atrial flutter. 

Atrial fibrillation codes include ICD-9-CM code 427.31 (Atrial fibrillation) and ICD-10-CM codes I48.0 (Paroxysmal atrial fibrillation), I48.1 (Persistent atrial fibrillation), I48.2 (Chronic atrial fibrillation), and I48.91 (Unspecified atrial fibrillation).

Atrial flutter codes include ICD-9-CM code 427.32 (Atrial flutter) and ICD-10-CM codes I48.3 (Typical atrial flutter), I48.4 (Atypical atrial flutter), and I48.92 (Unspecified atrial flutter).

Because the procedure usually happens in a facility, your physician would include his work in an E/M code rather than reporting the infusion. The facility would report the infusion. 

If the infusion took place in the office, use a push code such as 96374 (Therapeutic, prophylactic, or diagnostic injection [specify substance or drug]; intravenous push, single or initial substance/drug) for this 10 minute service.