Cardiology Coding Alert

Question: The cardiac electrophysiologist (EP) documented that in the hospital, he performed a comprehensive EP study that included bundle of His recording, induction of arrhythmia, and right atrial pacing. I thought 93620-26 was the correct answer, but I was told instead that I should report 93618-26, 93610-26, and 93600-26. Which is correct?

Ohio Subscriber

Answer: Based upon the information you have given, this actually qualifies as a limited EP study, not a comprehensive EP study. To report comprehensive EP study code 93620 the note must show that the cardiologist performed and documented all of the comprehensive study components, which include of all the following:

• 93600 (Bundle of His recording)
• 93602 (Intra-atrial recording)
• 93603 (Right ventricular recording)
• 93610 (Intra-atrial pacing)
• 93612 (Intraventricular pacing)
• 93618 (Induction of arrhythmia by electrical pacing).

Limited EP studies: Therefore, when the cardiologist does not perform the full-service package, you should report the individual components with their respective CPT^® codes. So, you would report: 93618-26 for the induction of arrhythmia, 93610-26 for the right atrial pacing, and 93600-26 for the bundle of His recording.

Comprehensive EP studies: However, if the cardiologist does perform all of the components of a comprehensive EP study, then your code choices are as follows:

• 93619 (Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, His bundle recording, including insertion and repositioning of multiple electrode catheters, without induction or attempted induction of arrhythmia)
• 93620 (Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with right atrial pacing and recording, right ventricular pacing and recording, His bundle recording).

Don't miss: If the cardiologist makes any attempt at induction (successful or not), you should report 93620. However, if the cardiologist makes no attempt at induction, you would report 93619.

Final note: If you're reporting only the professional component of the evaluation, remember to append modifier 26 (Professional component) to these EP codes.