Reader Question: Definition of Elective Not Always Clear
Document Elective Status of Cardioversion
Question: The definition of cardioversion 92960 reads in part, elective, electrical conversion of arrhythmia; external. What does elective mean in this definition? Should I use a different code if its not elective?
Minnesota Subscriber
Answer: The definition of elective for 92960 (Cardiover-sion, elective, electrical conversion of arrhythmia; external) is subject to debate. Some experts take it to mean a scheduled procedure. Others take it to mean that the cardioversion doesnt have to be done to save the patients life.
Take defibrillation, for example, which is not elective. A patient in ventricular fibrillation will die without defibrillation. But a patient with atrial fibrillation at a rate of 180 generally doesnt have to be cardioverted. The meaning of elective becomes complicated in the following scenario: A patient in a life-threatening arrhythmia is unstable and needs cardioversion. Although the procedure is not defibrillation, it isnt elective cardioversion either. If you dont code the procedure as elective, however, then theres no code for the service rendered.
Your documentation can help you. If the physicians documentation points toward elective status, then you can get your code cleared. Elective documentation, for example, might say, Patient in a fib with rapid response. Will attempt to slow with Cardizem. If unsuccessful, plan cardioversion with sedation. If you have time to sedate the patient, you have further indication of an elective procedure. Your chart should indicate that the cardioversion was planned and prepared for.
Reader Question reviewed by Sarah Goodman, MBA, CPC-H, CCP, president of SLG Inc. Consulting in Raleigh, N.C.
- Published on 2003-07-01
