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EP study, please help!

  1. #1
    Default EP study, please help!
    Medical Coding Books
    My Physician did an EP epicardial ablation along with another Physician who did a closure of the sternotomy and creation of pericardial window. (CPT 33025 and CPT 21750)

    I came up with:
    93652
    93613
    93618-26
    93612-26/59
    93600-26
    93603-26/59


    Three diagnostic catheters were advanced fluoroscopically to the right heart: one to the His Bundle recording area, and one to the right ventricular apex. The right internal jugular vein was cannulated using the same technique with the 8 French sheath for insertion of a posterior cardiac vein cannulation for mapping of VT from LV. 16 pole electrodes catheter was placed inside the posterior cardiac vein to map the LV postero-inferior wall. Ventricular thresholds were determined. The effective refractory period of the ventricle was determined by pacing at 2x threshold. Burst pacing and S1S2 programmed pacing was performed from the right ventricular apex to induce the clinical VT. Once the reliable VT was induced on Isuprel 3 ug/min infusion with RV pacing.

    3D mapping was done with Bio-sense -Carto Quick mapping system via pericardial window from the low median sternotmy completed by Dr. X. The electro-anatomical map of the LV was done to obtain voltage map and determine scar tissue. The LV had extensive scar from the apex to the lateral wall and the activation map was created based on the local electrograms. The earliest site was located at the small region close to the posterior-inferior wall of LV just lateral to the posterior descending coronary artery. Thermo-cool ablation of VT from the inferior posterior wall of LV.

    Would you code for anything else or am I way off on my codes?

  2. Default Possible solution to your problem
    Hi,

    Please refer somebody to verify these codes as i cannot vouch for its correctness I am also new to coding EP studies, per me codes should be

    93654 and 93623, rest of codes are included in comprehensive bundle

    Sincerely,

    Sudipt Shaw




    Quote Originally Posted by mariecass View Post
    My Physician did an EP epicardial ablation along with another Physician who did a closure of the sternotomy and creation of pericardial window. (CPT 33025 and CPT 21750)

    I came up with:
    93652
    93613
    93618-26
    93612-26/59
    93600-26
    93603-26/59


    Three diagnostic catheters were advanced fluoroscopically to the right heart: one to the His Bundle recording area, and one to the right ventricular apex. The right internal jugular vein was cannulated using the same technique with the 8 French sheath for insertion of a posterior cardiac vein cannulation for mapping of VT from LV. 16 pole electrodes catheter was placed inside the posterior cardiac vein to map the LV postero-inferior wall. Ventricular thresholds were determined. The effective refractory period of the ventricle was determined by pacing at 2x threshold. Burst pacing and S1S2 programmed pacing was performed from the right ventricular apex to induce the clinical VT. Once the reliable VT was induced on Isuprel 3 ug/min infusion with RV pacing.

    3D mapping was done with Bio-sense -Carto Quick mapping system via pericardial window from the low median sternotmy completed by Dr. X. The electro-anatomical map of the LV was done to obtain voltage map and determine scar tissue. The LV had extensive scar from the apex to the lateral wall and the activation map was created based on the local electrograms. The earliest site was located at the small region close to the posterior-inferior wall of LV just lateral to the posterior descending coronary artery. Thermo-cool ablation of VT from the inferior posterior wall of LV.

    Would you code for anything else or am I way off on my codes?

  3. Default Possible solution to your problem
    Hi,

    Please refer somebody to verify these codes as i cannot vouch for its correctness as I am new to coding EP studies, per me codes should be

    93654 and 93623, rest of codes are included in comprehensive bundle

    Sincerely,

    Sudipt Shaw




    Quote Originally Posted by mariecass View Post
    My Physician did an EP epicardial ablation along with another Physician who did a closure of the sternotomy and creation of pericardial window. (CPT 33025 and CPT 21750)

    I came up with:
    93652
    93613
    93618-26
    93612-26/59
    93600-26
    93603-26/59


    Three diagnostic catheters were advanced fluoroscopically to the right heart: one to the His Bundle recording area, and one to the right ventricular apex. The right internal jugular vein was cannulated using the same technique with the 8 French sheath for insertion of a posterior cardiac vein cannulation for mapping of VT from LV. 16 pole electrodes catheter was placed inside the posterior cardiac vein to map the LV postero-inferior wall. Ventricular thresholds were determined. The effective refractory period of the ventricle was determined by pacing at 2x threshold. Burst pacing and S1S2 programmed pacing was performed from the right ventricular apex to induce the clinical VT. Once the reliable VT was induced on Isuprel 3 ug/min infusion with RV pacing.

    3D mapping was done with Bio-sense -Carto Quick mapping system via pericardial window from the low median sternotmy completed by Dr. X. The electro-anatomical map of the LV was done to obtain voltage map and determine scar tissue. The LV had extensive scar from the apex to the lateral wall and the activation map was created based on the local electrograms. The earliest site was located at the small region close to the posterior-inferior wall of LV just lateral to the posterior descending coronary artery. Thermo-cool ablation of VT from the inferior posterior wall of LV.

    Would you code for anything else or am I way off on my codes?

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