Help with procedure code- Procainamide infusion study

Kcronin1122

Networker
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42
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0
Hi all,
I am hoping you can help me with finding a CPT for this procedure performed. (93623??)

Thank you!


ELECTROPHYSIOLOGY PROCEDURE REPORT: Procainamide infusion study


Pre-procedure diagnoses: Cardiac arrest

Post-procedure diagnoses: Cardiac arrest

HPI:

Consent:
This procedure was performed with direct participation of the staff cardiologist, Dr **** who was present and scrubbed for the case and agrees with the procedure note as written..

Patient gave informed consent for EP Study, Transseptal catheterization, coronary angiography, epicardial access, & RF ablation, after comprehending the risks, benefits, indications and alternatives.

Procedures performed:
1. Procainamide infusion study


Procedure time: 1 hrs 0 min

________________________________________________________
Procedure:
The patient was brought into the EP lab and hooked up to a 12-lead ECG machine. A baseline ECG was obtained, with no evidence of a type 1 Brugada pattern noted. Next, procainamide 839 mg (10mg/kg) was infused IV over 30 minutes, with a repeat ECG performed every 10 minutes. The patient's BP and HR was monitored continuously. At the end of 60 minutes, no type 1 Brugada pattern was seen. The patient was observed another 30 minutes with 3 more ECGs in holding after that. No arrhythmias or repolarization abnormalities were noted at any time. The patient was discharged home in stable condition

________________________________________________________
Complications: none

________________________________________________________
Summary:
1) No type 1 Brugada pattern invoked with procainamide infusion.
2) Prior cardiac arrest likely due to hypoxia and infection, not Brugada syndrome.
________________________________________________________
Recommendations:
1) Followup with me as outpatient. Continue current medications
 
Messages
16
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Rich Square, North Carolina
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Hi! I am doing further research into your question, and I will get back to you ASAP. I did just want to doublecheck about the procedure section above. Is that all the info from the cardiologist's documentation about what happened in the EP lab? I just wanted to make sure I understand exactly which EP procedures the cardiologist performed. This will help me with my research. Thanks!

Meagan Williford, CPC, BA, MA
Development Editor
AAPC
 

Kcronin1122

Networker
Messages
42
Best answers
0
Hi! I am doing further research into your question, and I will get back to you ASAP. I did just want to doublecheck about the procedure section above. Is that all the info from the cardiologist's documentation about what happened in the EP lab? I just wanted to make sure I understand exactly which EP procedures the cardiologist performed. This will help me with my research. Thanks!

Meagan Williford, CPC, BA, MA
Development Editor
AAPC
Yes, this is all that is documented in the body of the note.

Thank you for your help!
 
Messages
16
Location
Rich Square, North Carolina
Best answers
0
Hi all,
I am hoping you can help me with finding a CPT for this procedure performed. (93623??)

Thank you!


ELECTROPHYSIOLOGY PROCEDURE REPORT: Procainamide infusion study


Pre-procedure diagnoses: Cardiac arrest

Post-procedure diagnoses: Cardiac arrest

HPI:

Consent:
This procedure was performed with direct participation of the staff cardiologist, Dr **** who was present and scrubbed for the case and agrees with the procedure note as written..

Patient gave informed consent for EP Study, Transseptal catheterization, coronary angiography, epicardial access, & RF ablation, after comprehending the risks, benefits, indications and alternatives.

Procedures performed:
1. Procainamide infusion study


Procedure time: 1 hrs 0 min

________________________________________________________
Procedure:
The patient was brought into the EP lab and hooked up to a 12-lead ECG machine. A baseline ECG was obtained, with no evidence of a type 1 Brugada pattern noted. Next, procainamide 839 mg (10mg/kg) was infused IV over 30 minutes, with a repeat ECG performed every 10 minutes. The patient's BP and HR was monitored continuously. At the end of 60 minutes, no type 1 Brugada pattern was seen. The patient was observed another 30 minutes with 3 more ECGs in holding after that. No arrhythmias or repolarization abnormalities were noted at any time. The patient was discharged home in stable condition

________________________________________________________
Complications: none

________________________________________________________
Summary:
1) No type 1 Brugada pattern invoked with procainamide infusion.
2) Prior cardiac arrest likely due to hypoxia and infection, not Brugada syndrome.
________________________________________________________
Recommendations:
1) Followup with me as outpatient. Continue current medications
 
Messages
16
Location
Rich Square, North Carolina
Best answers
0
Hi all,
I am hoping you can help me with finding a CPT for this procedure performed. (93623??)

Thank you!


ELECTROPHYSIOLOGY PROCEDURE REPORT: Procainamide infusion study


Pre-procedure diagnoses: Cardiac arrest

Post-procedure diagnoses: Cardiac arrest

HPI:

Consent:
This procedure was performed with direct participation of the staff cardiologist, Dr **** who was present and scrubbed for the case and agrees with the procedure note as written..

Patient gave informed consent for EP Study, Transseptal catheterization, coronary angiography, epicardial access, & RF ablation, after comprehending the risks, benefits, indications and alternatives.

Procedures performed:
1. Procainamide infusion study


Procedure time: 1 hrs 0 min

________________________________________________________
Procedure:
The patient was brought into the EP lab and hooked up to a 12-lead ECG machine. A baseline ECG was obtained, with no evidence of a type 1 Brugada pattern noted. Next, procainamide 839 mg (10mg/kg) was infused IV over 30 minutes, with a repeat ECG performed every 10 minutes. The patient's BP and HR was monitored continuously. At the end of 60 minutes, no type 1 Brugada pattern was seen. The patient was observed another 30 minutes with 3 more ECGs in holding after that. No arrhythmias or repolarization abnormalities were noted at any time. The patient was discharged home in stable condition

________________________________________________________
Complications: none

________________________________________________________
Summary:
1) No type 1 Brugada pattern invoked with procainamide infusion.
2) Prior cardiac arrest likely due to hypoxia and infection, not Brugada syndrome.
________________________________________________________
Recommendations:
1) Followup with me as outpatient. Continue current medications
Have you considered unlisted code 93799 (Unlisted cardiovascular service or procedure)? Although the medical documentation indicates an EP study, the cardiologist did not place catheters in the ventricles, atria, or bundle of HIS.
Meagan Williford, CPC, BA, MA
Development Editor
AAPC
 

TWinsor

Guru
Messages
181
Location
Columbus, OH
Best answers
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Have you considered unlisted code 93799 (Unlisted cardiovascular service or procedure)? Although the medical documentation indicates an EP study, the cardiologist did not place catheters in the ventricles, atria, or bundle of HIS.
Meagan Williford, CPC, BA, MA
Development Editor
AAPC
IF this is performed in the facility setting, prior to loop recorder placement, is this a billable service?
 
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