I have never coded a cardioversion that wasn't done externally before, so this one has me stumped. Here is the report. Any idea of how to code this for the doctor when done at the hospital?
PROCEDURE PERFORMED: Electrical cardioversion via his implantable
defibrillator.
INDICATION: History of paroxysmal atrial fibrillation, history of some
decompensating symptomatology, congestive heart failure, worsening shortness of breath. He has been on adequate thromboembolic protection for the past month and he has had titration of his amiodarone without successful return to a sinus mechanism.
DESCRIPTION OF PROCEDURE: Patient was brought to the catheterization recovery
room. The patient has an implantable biventricular defibrillator in place.
Atrial arrhythmia was confirmed by electrogram assessment through the device.
Patient was converted back to sinus rhythm through internal cardioversion ____
35 joules. Successfully converted back to sinus mechanism. Sinus mechanism
confirmed by electrogram assessment through his device. Atrial sensing BiV
pacing. Lower pacing rate of his device is 60 beats per minute. No
procedural complications.
IMPRESSION:
1. Paroxysmal atrial fibrillation.
2. Successful cardioversion via his implantable device.
PLAN: Continue thromboembolic protective agents with Eliquis. Continue
antiarrhythmic therapy with amiodarone 200 mg twice daily.
PROCEDURE PERFORMED: Electrical cardioversion via his implantable
defibrillator.
INDICATION: History of paroxysmal atrial fibrillation, history of some
decompensating symptomatology, congestive heart failure, worsening shortness of breath. He has been on adequate thromboembolic protection for the past month and he has had titration of his amiodarone without successful return to a sinus mechanism.
DESCRIPTION OF PROCEDURE: Patient was brought to the catheterization recovery
room. The patient has an implantable biventricular defibrillator in place.
Atrial arrhythmia was confirmed by electrogram assessment through the device.
Patient was converted back to sinus rhythm through internal cardioversion ____
35 joules. Successfully converted back to sinus mechanism. Sinus mechanism
confirmed by electrogram assessment through his device. Atrial sensing BiV
pacing. Lower pacing rate of his device is 60 beats per minute. No
procedural complications.
IMPRESSION:
1. Paroxysmal atrial fibrillation.
2. Successful cardioversion via his implantable device.
PLAN: Continue thromboembolic protective agents with Eliquis. Continue
antiarrhythmic therapy with amiodarone 200 mg twice daily.
