Cardiology Coding Alert

You Be the Coder:

Look for Lead Analysis Code

Published on Thu Jun 12, 2014

Question: A surgeon who isn’t in our practice performed epicardial lead placement for an ICD. The generator will be placed later. My cardiologist performed intraoperative epicardial lead analysis and testing for one lead. What code should we use?

Codify Subscriber

Answer: You should report this lead testing using 93640 (Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation [induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination] at time of initial implantation or replacement). Modifier 26 (Professional component) applies if you’re reporting only the professional component.

Keep in mind: If the cardiologist also tested the generator at that same intraoperative session, you would instead report 93641 (…with testing of single or dual chamber pacing cardioverter-defibrillator pulse generator).

And, as the 93640 and 93641 descriptors indicate, the codes apply to testing “at time of initial implantation or replacement.” If the physician instead performs the testing at a different session, such as the next day or hours after the operation, report 93642 (Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator [includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parameters]).

Bonus tip: Look for the abbreviation DFT to identify this service. DFT stands for defibrillation threshold testing

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