Wiki ATP

[christinerw27@gmail.com]

This person came in for a cardioversion. They pace-terminated through his device instead of externally shocking, as outlined below.
input on how this can be billed is greatly appreciated.


We attempted to pace-terminate using decremental cycle lengths,
and successfully pace-terminated atrial flutter to
sinus rhythm. The patient tolerated this well and left the
cardioversion room awake and in stable condition.

Pre-DCCV ECG: Atrial flutter VP, 60 bpm
Post-DCCV ECG: Sinus rhythm ASVP 70-80 bpm

IMPRESSION:
Successful pace-termination of atrial flutter to
sinus rhythm.
Interrogation:
Battery voltage/time to ERI: 9.5 years
Presenting rhythm: Atrial flutter, v-paced cycle length ~200
Underlying rhythm: atrial flutter
Post-pace termination rhythm: A-sensed, v-paced
Mode, base and upper track rate: DDD 60-130

Lead Testing
P waves: 8.7mv A thresh: N/A A imp: 637ohms
R waves: paced RV thresh: 0.7V@ 0.4ms RV imp: 645ohms

Diagnostics:
AP: <1%
VP: 82%
Events: No events

Summary:
1. Successfully pace-terminated atrial flutter, with return to
AS-VP rhythm following this
1. Pacer function normal with acceptable lead measurements and
battery status
2. Programming changes: None

 

[Jim Pawloski]

Code 92961 for Cardioversion, elective, electrical conversion of arrythmia, internal.

 

[Margaret Morgan]

This is what dr. Z says about that pacing cardioversion.
If performed via a pacemaker, I would recommend code 93724; however, code 93724 is specific to pacemaker. If done with an ICD, I would recommend unlisted code 93799. -Dr. Z