# 93799 for transseptal puncture during EP



## jtuominen (Oct 1, 2009)

Well, Im back again asking about how others are accounting for transseptal punctures used to advance ablation catheters during EP studies... I posted about this back in April when my docs wanted to use 93524 or 93527 to account for this technique. And seemed to get and all around resounding "no" to that. But now we have heard some news that some coders are starting to bill 93799 to account for the extra work done to do the transseptal puncture, and aligning the price/RVUs based on an average of 93524 and 93527. Anyone on here doing this? Any thoughts?

Thanks!
Jayna
RHIA, CIRCC


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## coding?4u (Nov 20, 2009)

We are adding modifer 22 to the ablation for transeptals.  Prior to this we were billing the 93527.
C. Bub 
CPC


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## Mikiu2000 (Nov 21, 2009)

*transeptal puncture*

Medicare prohibits the use of codes 93527 and 93524 with code 93651. This is because it is rare that a full and complete right and left heart catheterization is performed when conducting an ablation. Medicare does allow the assignment of modifier 59 to the heart catheterization codes 93527 and 93524 as long as the documentation supports the performance of a full and complete heart catheterization*. Compare the dictation of a full right and left heart cath with the documentation of the physician for a transeptal approach to perform an ablation. In many cases it is quite different and all the elements of a heart catheterization as described in the CPT manual are not met. 



*full and complete transeptal cath includes all presures of RHC & LHC as well as assessment of valves

I bill Ablation with a 22 modifier if transseptal puncture is also preformed.


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