Cardiology Coding Alert

Question: In a patient with paroxysmal atrial fibrillation, the EP performed catheter ablation. She performed transseptal puncture and injected dye to image the left atrium. She performed 3D mapping and successfully performed extensive encircling pulmonary vein isolation. Which ICD-10 and CPT^® codes should I report?

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Answer: For pulmonary vein isolation, you should report 93656 (Comprehensive electrophysiologic evaluation including transseptal catheterizations, insertion and repositioning of multiple electrode catheters with induction or attempted induction of an arrhythmia including left or right atrial pacing/recording when necessary, right ventricular pacing/recording when necessary, and His bundle recording when necessary with intracardiac catheter ablation of atrial fibrillation by pulmonary vein isolation).

This treatment involves using a specialized catheter to apply energy (direct current, freezing, etc.) that creates scarring around where the pulmonary veins connect to the left atrium. The goal is to block irregular impulses.

Don’t miss: You may report the 3D mapping separately using +93613 (Intracardiac electrophysiologic 3-dimensional mapping [List separately in addition to code for primary procedure]).

ICD-10: For the diagnosis, you should report the code specific to the paroxysmal form, I48.0 (Paroxysmal atrial fibrillation).