Cardiology Coding Alert

Question: Can I report 36000 and 76000 separately when billing 93650?

Florida Subscriber

Answer: No. According to Correct Coding Initiative (CCI) edits, including the April 2017 version, you should not report Column 1 code 93650 (Intracardiac catheter ablation of atrioventricular node function, atrioventricular conduction for creation of complete heart block, with or without temporary pacemaker placement) with Column 2 Codes 36000 (Introduction of needle or intracatheter, vein) and 76000 (Fluoroscopy [separate procedure], up to 1 hour physician or other qualified health care professional time, other than 71023 or 71034 [e.g., cardiac fluoroscopy]) for the same patient on the same date of service.

Important: Because the edits for the 93650/36000 and 93650/76000 code pairs have a modifier indicator of 1, when appropriate, you can append a modifier to the Column 2 code to override the edits. However, never use a modifier just to bypass the edits. You must ensure that the documentation and clinical circumstances support your reasoning to use the modifier, such as being used in a separate session.

Bonus tip: Code 93650 was one of the codes that CPT^® 2017 removed moderate sedation from, so now you can separately report moderate sedation.

If the same physician or qualified healthcare professional who performs the procedure also performs the moderate sedation, use 99151, 99152, and +99153.

If a different physician or qualified healthcare professional performs the procedure and the moderate sedation, that provider will turn to 99155, 99156, and +99157.