# elective external cardioversion w/ICD



## nparmele (Nov 30, 2010)

Patient comes in for elective external cardioversion due to afib.  Patient was successfully cardioverted with a single shock USING HIS OWN DEFIBRILLATOR.  Sedation used is Versed & Propofol.

Can I code 92960?

I code for facility & physician.


----------



## theresa.dix@tennova.com (Nov 30, 2010)

there is no listed CPT code that accurately reflects cardioversion through an implanted pacemaker or defibrillator.

According to the instructions in the front of the CPT book, we should not report a CPT code that merely approximates the service provided; if no CPT accurately describes the service, we must use an unlisted code such as 93799

(Unlisted cardiovascular service or procedure).This is the code that should be used to report cardioversion and overdrive pacing performed through an implanted device. Is this what you think was done?


----------



## Cyndi113 (Nov 30, 2010)

His own defibrillator as in an ICD or he has a machine with paddles?

If his own machine: I would say for the facility side you cannot bill the cardioversion. But you can bill for the meds. However, for the physician I would say definitely yes. It was his skill, experience and liability if it failed. 

Don't think you can bill for an ICD shock...

Am really interested to see what others have to say.


----------



## nparmele (Dec 1, 2010)

Good morning Cyndi and Theresa,
Thank you so much for your replies!  I greatly appreciate it.

In his op note the doctor writes "He was successfully cardioverted to a normal sinus rhythm with a single shock using his defibrillator at 31 joules."

I am going to query the doctor to get clarification if he used the paddles or not.  If he did not, then I agree that 92960 does not cover what he did and I will bill with the unlisted procedure.  When I was researching on line yesterday, I did find an article that stated paddles must be placed 12 cm from the ICD or pacemaker.


----------

