Cardiology Coding Alert
Recording and Pacing
New York Subscriber
Answer: The electrophysiologist is recording when he places an electrode in a certain location of the heart to assess electrical activity. If you can separately report this procedure, you may report 93600 (Bundle of His recording) when the physician places an electrode at the bundle of His. Or you may report 93602 (Intra-atrial recording) for intra-atrial recording and 93603 (Right ventricular recording) when the physician records activity in the right ventricle.
To bill "pacing," make sure the electrophysiologist administers electrical impulses to specific areas of the heart. The procedure allows your physician to assess how various portions of the heart react to electrical impulses. Pacing is also a good tool to evaluate whether certain heart pathways carry electrical impulses to appropriate locations and the conducted impulses' speed.
Example: The physician paces from the atrium. In this case, assign 93610 (Intra-atrial pacing). If the physician administers intraventricular pacing, report 93612 (Intraventricular pacing).
As always, make sure the medical documentation explains what the physician did so you'll use the correct code. Be careful that you don't separately report one of the pacing or recording codes when you should assign a comprehensive EP study code. For instance, if the electrophysiologist performs pacing and recording from the atrium and ventricle, and performs recording from the His bundle, you can list 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).
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