# EP Ablation Help



## dpumford (Dec 3, 2009)

Hi:  I am hoping for a couple of coding opionions for this senario, please!!

Rt groin was acessed, using flouroscopic guidance, the axillary vein was cannulated.  The 5-french introducer were places into the left axillar vein w/o  complication.  Multipolar coronary sinus cath ws advanced into the coronary sinus.  A 7-french troduces was placed in the rt fem vein. an 8-mm tipped ablation catheter was advanced into the rt atrium.

Conduction times fro the coronary sinus to 7 o'clock on the tricusped isthmus were measured in both directions.  In both directions, conduction time in the baseline state is 175mm.

Attempts a inducing atrial flutter were then made from Multiple Pacing sites. We were unable to induce AF.  the pt has had documented episodes, and we decided to place a line along the cavatricuspid isthmus.  This was done w/drag burns. Three-D map of annulus and Inferior vena cava  were made.  His position was identified.  It showed A-V interval(93602??) of 90, H-V interval of 40 (93600-26??)ms.  After placement of line burns attempts at inducing AF were unsuccessful

I am not sure what to give him for the EP part of this. Ablation is 93651 & 93613-26 for mapping.

Any advice would be very appreciated~ Thanks


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## andersee (Dec 4, 2009)

The documentation below is not ideal but you could bill 93620 with a modifier 52 (two sites, his and RA were cath'd, recording, pacing with attempted induction), 93621 (LA), and 93613 (mapping). I would not bill 93651 unless there was documentation that ablation was done that was not included in your email.

Erin


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