Wiki 93620 or ??

[christinerw27@gmail.com]

pt comes in for comp EP eval (93620) BUT only performed the following:
Vascular sites were accessed using the percutaneous modified Seldinger technique under ultrasound guidance. Access was obtained via right femoral vein with a 7F sheath . Catheters were advanced fluoroscopic guidance. A quadrapolar catheters was advanced to the RV apical position.
Ventricular tachycardia induction attempt: From the right ventricular apex and RV base, up to triple extra-stimulus pacing at 600ms and 400 ms failed to induced any sustained ventricular arrhythmias

Because of the findings, an upgrade to a CRT-D was not performed (CRT/P was)
Should I be billing the VT induction attempt with a different code, as only 1 catheter and 1 site were used?

 

[vidraj]

Check with your surgeon if you can submit 93456- 59, 52 (RHC with reduced services) and the 93618 (Induction of arrhythmia by electrical pacing - if this was not done this code allows modifier 52 as well). This is better than not getting reimbursed at all.
If done at a facility, include the professional service modifier 26 too.

 

[Jim Pawloski]

This is an EP study, not a heart cath since there are no pressures or imaging of the coronary vessels. I would code 93618 and 93612 with a modifier-59.

 

[christinerw27@gmail.com]

thank you
makes sense now..

 

[vidraj]

This is an EP study, not a heart cath since there are no pressures or imaging of the coronary vessels. I would code 93618 and 93612 with a modifier-59.

Thank you for correcting Jim
I missed paying attention to this documentation for the 93612 - "From the right ventricular apex and RV base, up to triple extra-stimulus pacing at 600ms and 400 ms"