Cardiology Coding Alert

Question: Is it ever possible to report an ECG after elective cardioversion, or is the ECG always included?

Illinois Subscriber

Answer: According to CPT® Assistant (January 2012) you may report additional studies when documentation supports medical necessity: "In certain cases a post-cardioversion ECG is performed to diagnose unexpected arrhythmias after cardioversion or to define ST wave changes. Medical record documentation should reflect this eventuality."

Keep in mind: "Any electrocardiogram (ECG) performed prior to or during cardioversion is included in CPT® code 92960, Cardioversion, elective, electrical conversion of arrhythmia; external," CPT® Assistant states.

Ask yourself: Was the physician still present when the new indication occurred after the initial service was performed? Was the initial post-cardioversion ECG done to confirm whether the cardioversion was successful? If so, experts recommend including those ECGs in 92960. Sometimes before the physician disburses a patient (during the same session), the patient converts back to an abnormal rhythm. When this happens, the physician performs additional cardioversions. If the physician has disbursed the patient and a new indication occurs, then reporting a separate ECG service may be appropriate. Remember to append modifier 59 (Distinct procedural service) to indicate it was a separate service.