Hi, I need help with figuring out the coding for an EP study that one of my physicians performed recently and is now asking me what codes I will be using. I am stumped on how to code this procedure, and have even asked a coworker for help who is also just as stumped as me. Please see below for what was done:
PREPROCEDURE DIAGNOSES:
1. Persistent atrial fibrillation.
2. History of cryoballoon pulmonary vein isolation and radiofrequency CTI
ablation at Sunrise Hospital on 11/02/2022.
ADDITIONAL POSTPROCEDURE DIAGNOSIS:
EP study evidence of intact bidirectional block across the CTI and chronically
isolated pulmonary veins x4 from prior ablation.
PROCEDURES:
1. Linear cryoballoon catheter ablation of the left atrium along its roof for
persistent atrial fibrillation.
2. Cryoballoon catheter ablation of posterior wall of the left atrium for
substrate modification for treatment of persistent atrial fibrillation.
3. Transesophageal echocardiogram.
4. Cardioversion.
5. Ultrasound guidance for femoral venous access x4.
6. Intracardiac echocardiography (ICE).
7. Three-dimensional electroanatomic map using the NavX mapping system.
8. Comprehensive electrophysiology study.
9. Vascular closure device insertion with Vascade.
In the procedure report the doctor does not perform a PVI, since one was done previously. He only goes through the pulmonary veins with a catheter to then do the ablation of the left atrium roof and then the wall. How would this be coded? Would it still be the 93656? He did do a previous PVI ablation in 2022 on this same patient.
Thank you for any help!!
PREPROCEDURE DIAGNOSES:
1. Persistent atrial fibrillation.
2. History of cryoballoon pulmonary vein isolation and radiofrequency CTI
ablation at Sunrise Hospital on 11/02/2022.
ADDITIONAL POSTPROCEDURE DIAGNOSIS:
EP study evidence of intact bidirectional block across the CTI and chronically
isolated pulmonary veins x4 from prior ablation.
PROCEDURES:
1. Linear cryoballoon catheter ablation of the left atrium along its roof for
persistent atrial fibrillation.
2. Cryoballoon catheter ablation of posterior wall of the left atrium for
substrate modification for treatment of persistent atrial fibrillation.
3. Transesophageal echocardiogram.
4. Cardioversion.
5. Ultrasound guidance for femoral venous access x4.
6. Intracardiac echocardiography (ICE).
7. Three-dimensional electroanatomic map using the NavX mapping system.
8. Comprehensive electrophysiology study.
9. Vascular closure device insertion with Vascade.
In the procedure report the doctor does not perform a PVI, since one was done previously. He only goes through the pulmonary veins with a catheter to then do the ablation of the left atrium roof and then the wall. How would this be coded? Would it still be the 93656? He did do a previous PVI ablation in 2022 on this same patient.
Thank you for any help!!