ED Coding and Reimbursement Alert

Question: Is 92960 the correct code for reporting the defibrillation performed for cardiac arrest or cardiac arrhythmia?

Louisiana Subscriber  
Answer: Cardioversion and defibrillation offer two different approaches in shocking the heart to alter its rhythm, but only elective cardioversion is reportable with 92960 (cardioversion, elective, electrical conversion of arrhythmia; external). Elective cardioversion may be used to treat atrial fibrillation and atrial flutter if anti-arrhythmic drugs have failed to convert the heart back to normal sinus rhythm or if a patient is hemodynamically unstable.
 
There is no CPT code for reporting defibrillation as a separately billable service. It is generally bundled into codes used for procedures such as critical care at the end of open-heart surgery, during cardiac catheterization or during an electro-physiological procedure. Although both procedures provide a similar treatment, elective cardioversion is a planned event and defibrillation is performed as an emergency measure and is generally part of the care provided during a medical emergency. The diagnosis code for cardiac arrest is 427.5; the code for cardiac arrhythmia is 427.9.