Wiki Cardiac Ablation Add On Code CPT 93623 Infusion Guidelines


Santa Clara, CA
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From what I understand from CPT 93623 (programmed stimulation and pacing after intravenous drug infusion [list separately in addition to code for primary procedure), this code is to be removed when done AFTER cardiac ablations to confirm results per the CPT book and NCCI edit below.

I am about to start coding EP procedures and providers are billing this CPT 93623 all over the place when done AFTER ablation, with verbiage such as “after rv ablation …. high does isoproterenol challenge no reconnection into the PVs no extra pulmonary triggers, no induction of atrial arrhythmia."

Should this CPT 93623 be removed? If I do, I will be doing this differently than the provider’s previous coder. My concern is the verbiage stating ‘no induction of arrhythmia’, as I’ve read on the web that cpt 93623 may be able to be reported after ablation if to test for arrhythmia, but this seems to be a copy paste statement on all EP procedures.

Per NCCI edits CPT 93623 - CPT code 93623 (programmed stimulation and pacing after intravenous drug infusion) is an add-on code that may be reported per CPT Manual instructions only with CPT codes 93610, 93612, 93619, 93620, or 93653-93656. Although CPT code 93623 may be reported for intravenous drug infusion for diagnostic programmed stimulation and pacing, it should not be reported for injections drug with stimulation and pacing following an intracardiac catheter ablation procedure (e.g., CPT codes 93650-93657) to confirm adequacy of the ablation. Confirmation of the adequacy ablation is included in the intracardiac catheter ablation procedure.

Thank you,
I might be wrong but I think the statement no induction of arrhythmia means that the isuprel couldn't reproduce the arrhythmia which is what they hope for after they've done the ablation. The administer the medication in hopes to see that they can't reproduce it. If they can reproduce it, they have to do a more detailed ablation. This is my limited understanding of this, so I could be wrong.
We do not charge CPT 93623 to test the efficacy of an ablation as per NCCI. However there are times when the physician documents the need to differentiate a different arrhythmia then this is coded. Additionally in some cases isuprel is given pre ablation to induce an arrhythmia in this case it is coded as well.

I would show your physicians the NCCI edit regarding this CPT code. I know it has been discussed many times.