Cardiology Coding Alert

Question: My cardiologist performed a comprehensive electrophysiologic study (EPS). He placed several sheaths for vascular access in the patient’s groin and passed electrode catheters into the patient’s body through these sheaths. My cardiologist used imaging guidance to guide the electrode catheters through the vascular system to the patient’s heart and placed the electrodes in the desired areas to check the heart’s electrical system. He induced an arrhythmia, performed right atrium and right ventricle pacing and recording, and performed His bundle recording. Once the evaluation is complete, my cardiologist used ablation to treat the patient’s supraventricular tachycardia by placing a specialized catheter at a single site to deliver energy that destroys the source of the problem. Finally, he removed all equipment and achieved hemostasis at the access sites. Which CPT^® code should I report on my claim?

Alabama Subscriber

Answer: You should report code 93653 (Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of an arrhythmia with right atrial pacing and recording, right ventricular pacing and recording (when necessary), and His bundle recording (when necessary) with intracardiac catheter ablation of arrhythmogenic focus; with treatment of supraventricular tachycardia by ablation of fast or slow atrioventricular pathway, accessory atrioventricular connection, cavo-tricuspid isthmus or other single atrial focus or source of atrial re-entry) in this situation. Code 93653 represents a comprehensive study with treatment, so you should not additionally report codes for the individual services included in this code.

Don’t miss: When your cardiologist performs ablation, you must read the medical documentation carefully to identify which type of arrhythmia he was treating because this detail will dictate your code choice. So, you should report code 93653 when your cardiologist performs catheter ablation to treat supraventricular tachycardia caused by dual atrioventricular nodal pathways, accessory atrioventricular connections, or other atrial foci.

Coding tip: The code descriptor for 93653 indicates that the cardiologist should perform right ventricular pacing and recording and His bundle recording “when necessary.” CPT^® requires that if your cardiologist could not perform one or more of those components, then he should document why he didn’t perform the service in the medical record.