Anesthesia Coding Alert

Question: What are the surgical and anesthesia codes for noninvasive pacemaker defibrillator stimulation (NIPS)?


Texas Subscriber

Answer: The physician performs NIPS in three stages, and you need codes for each phase. First, you should report 93624 (Electrophysiologic follow-up study with pacing and recording to test effectiveness of therapy, including induction or attempted induction of arrhythmia) for the evaluation of ongoing drug therapy.

The second surgical code you will need is 93724 (Electronic analysis of antitachycardia pacemaker system [includes electrocardiographic recording, programming of device, induction and termination of tachycardia via implanted pacemaker, and interpretation of recordings]) when the physician checks the pacemaker's effectiveness.
 
The final surgical code is 93642 (Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator [includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parameters]) for follow-up evaluations and programming.

Each of these surgical codes crosses to anesthesia code 00537 (Anesthesia for cardiac electrophysiologic procedures including radiofrequency ablation). Some coders recommend reporting 00537, but others suggest 01999 (Unlisted anesthesia procedure[s]) instead because the physician only stimulates the defibrillator instead of performing a surgical procedure. Discuss the case with the anesthesiologist to help determine which code is more appropriate.