# Defibrillator



## akmorgan (May 31, 2010)

We have an office that is putting a defibrillator in for emergency use..my question is, if it has to be used, how would we code for this?  
Thank you.


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## sabarinath (Jun 1, 2010)

*defibrillator*

hi,
33249 is the code for debrillator

regards


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## kjohnson (Jun 1, 2010)

what about code 92960?


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## jgf-CPC (Jun 1, 2010)

Look up Cardioversion and the 92960 code.


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## donnasimms@verizon.net (Jun 1, 2010)

*Donna S*

I recommend using the code for CPR (92950) because that is the purpose for this equipment in the event of a cardiac arrest.


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## RebeccaWoodward* (Jun 1, 2010)

92950=Cardiopulmonary resuscitation (CPR) is a *manual *attempt at restarting a patient's heart and lungs when cardiopulmonary arrest occurs. Typically led by a health care provided certified in CPR, the lungs are filled with air by holding the nose and breathing throught the mouth or performed with a ventilating bag. Chest compressions are also performed at intervals, alternating with the the air in the lungs. A defibrillator may be used to shock the heart into starting. 

92960=External cardioversion, in which a defibrillator's paddles are placed on a patient's chest and regular electrical pulses used to regulate the heartbeat. Code 92961 for an internal procedure.

My first thought was 92960; however, CPT Assistant has a couple of articles relating to this service suggesting otherwise.  Excerpt from June '93...

Code 92960 is used to report the physician services related to the elective cardioversion as described in this article. There *is no separate CPT code to use to report defibrillation*. Although both procedures shock the heart to alter its rhythm, elective cardioversion is a planned event; defibrillation is performed as an emergency measure and is generally part of the care provided during a medical emergency such as cardiac arrest/ventricular fibrillation or is an integral part of another procedure, such as cardiac surgery.

Nov. 2000...

CPT codes 92960 and 92961 are used to report cardioversion. Code 92960 specifically describes elective (nonemergency) external electrical cardioversion. Elective cardioversion is most often used to treat atrial fibrillation and atrial flutter if anti-arrhythmic drugs fail to convert the heart back to normal sinus rhythm, or if the patient is hemodynamically unstable. The electric shock given in cardioversion is synchronized (ie, timed to occur during the R wave of the electrocardiogram). The patient will have his/her heart rhythm monitored for several hours after the procedure to ensure the rhythm remains stable. 

Questions are often raised regarding use of the cardioversion codes to report defibrillation. Defibrillation is the delivery of an electrical impulse to the heart. This impulse is intended to interrupt life-threatening abnormal rhythms (eg, ventricular fibrillation, pleiomorphic ventricular tachycardia or ventricular tachycardia associated with shock) and allow the normal sinus impulse and electrical conduction to resume. The electrical impulse must be strong enough to cause depolarization (neutralization of the positive and negative electrical charges) of a large percentage of the myocardium. The timing of the defibrillation shock is not synchronized to the cardiac cycle (ie, it is not delivered during an R wave). 

*There is no CPT code to report defibrillation as a procedure performed in isolation*. Defibrillation may be performed as part of critical care services, at the end of open heart surgery, during cardiac catheterization and coronary angiography, or during an electrophysiological procedure. Defibrillation is often a component of cardiac resuscitation, especially in adults. In all of these situations, defibrillation is not a separately reportable service.


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## BrigitteS  (Jun 1, 2010)

*AICD Implant*



amymorgan said:


> We have an office that is putting a defibrillator in for emergency use..my question is, if it has to be used, how would we code for this?
> Thank you.


What does it mean defibrillator for emergency use. Either the patient is  in need of a defibrillator or not. The code for the ICD is 33249 for one or two leads. If DFT testing was done at the time of implant you can also charge 93641-26 and the S&I code for the ICD is 71090-26. If an add'l Bi-vent lead was placed you can also charge 33225 (at the time of original implant of a new system or a new generator only). If Bi-vent lead is placed to an existing generator the code is 33224.


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## RebeccaWoodward* (Jun 1, 2010)

I wasn't under the impression that the poster was looking for the surgical procedure (33249) which carries a 90 day global...but I could be wrong.


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## sbicknell (Jun 2, 2010)

Code critical care. Document what was done, specifically who did what (nurses, MD etc) and time spent. Your diagnosis should support the CC

92960 is not valid as it is elective procedure only (treatment of AFib)

92950 is not valid as it is inclusive to Critical Care

Here is a paste:
_There is no code for defibrillation or cardioversion administered to patients in an emergency situation. The service is not supposed to be billed separately because it is considered part of the larger service that often accompanies it, such as cardiopulmonary resuscitation, emergency department (ED) evaluation and management (E/M) services, critical care services, cardiac catheterization, implantable-cardio defibrillator (ICD) implantation, other electrophysiological procedures or at the end of open heart surgery_


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