Cardiology Coding Alert

Question: My provider tested the electrical activity of a single-chamber cardioverter defibrillator device’s leads and its ability to respond to and regulate an abnormal heartbeat. They performed the tests when the device was first implanted. They also tested the device’s power source, controller, and pulse generator. They connected the leads to a monitoring device and recorded the electrical signals. My provider also paced the patient’s heart and induced arrhythmias to test the device’s ability to sense and arrest an abnormal rhythm and return to a normal heartbeat. They also tested the pulse generator. How should I report this procedure?

Ohio Subscriber

Answer: You should report 93641 (Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination) at time of initial implantation or replacement; with testing of single or dual chamber pacing cardioverter-defibrillator pulse generator) on your claim.

Don’t miss: You cannot separately report an electrophysiologic (EPS) evaluation and programming of a non-implantable cardioverter defibrillator at the time of insertion, but you can for an implantable cardioverter defibrillator by appending modifier 26 (Professional component).

Do not separately report the induction of arrhythmia with 93618 (Induction of arrhythmia by electrical pacing) or internal cardioversion with +92961 (Cardioversion, elective, electrical conversion of arrhythmia, internal, separate procedure). These services are part of 93641.

Meagan Williford, BA, MA, CPC, Contributing Writer