bhargavi
Guru
CLINICAL INDICATIONS
This is a 70 years old noninsulin dependent diabetic, hypertensive,
hyperlipidemic white male, nonsmoker with a history of chronic left bundle
branch block and a Lexus scan thallium stress test suggestive of inferoapical
myocardial infarction with mild peri infarct ischemia in November. The
patient was hospitalized with probably pneumonia complicated by rapid atrial
fibrillation and atrial flutter in December 2013. Prior to that
hospitalization, he was started on hydralazine and symptoms began around that
time.
PROCEDURE
The patient was brought to the catheterization laboratory where he was
appropriately sedated by Anesthesia. Please refer to their records for
details. After adequate anesthesia, synchronized electrical cardioversion was
attempted at 150 joules with ads in anterior positions, but without success. A
second attempt at electrical cardioversion was attempted with pads in anterior
position at 200 joules and was also unsuccessful. Finally, a third attempt at
electrical cardioversion was performed at 200 joules with pads in anterior and
posterior position but this also remained unsuccessful.
IMPRESSION
Unsuccessful attempted electrical cardioversion.
should I still bill 92960 for this cardioversion?
is there a modifier I can use for this unsuccessful?
thanks in advance
This is a 70 years old noninsulin dependent diabetic, hypertensive,
hyperlipidemic white male, nonsmoker with a history of chronic left bundle
branch block and a Lexus scan thallium stress test suggestive of inferoapical
myocardial infarction with mild peri infarct ischemia in November. The
patient was hospitalized with probably pneumonia complicated by rapid atrial
fibrillation and atrial flutter in December 2013. Prior to that
hospitalization, he was started on hydralazine and symptoms began around that
time.
PROCEDURE
The patient was brought to the catheterization laboratory where he was
appropriately sedated by Anesthesia. Please refer to their records for
details. After adequate anesthesia, synchronized electrical cardioversion was
attempted at 150 joules with ads in anterior positions, but without success. A
second attempt at electrical cardioversion was attempted with pads in anterior
position at 200 joules and was also unsuccessful. Finally, a third attempt at
electrical cardioversion was performed at 200 joules with pads in anterior and
posterior position but this also remained unsuccessful.
IMPRESSION
Unsuccessful attempted electrical cardioversion.
should I still bill 92960 for this cardioversion?
is there a modifier I can use for this unsuccessful?
thanks in advance
