Cardiology Coding Alert

Question: What code would I use for procainamide challenge used to rule out Brugada syndrome?

Codify Member

Answer: This test is often performed in a hospital because there’s a possibility it will trigger a life-threatening heart arrhythmia. In that setting, the services the physician may report are limited. An E/M code may be appropriate depending on the services the cardiologist provided.

In the test, the patient has a baseline electrocardiogram (ECG) followed by an infusion of procainamide, an antiarrhythmic drug. The patient then has ECGs repeated at intervals so the physician can look for the Brugada sign. The facility will bill the infusion and supply the drug. If the physician provides separate ECG interpretation reports you may code 93010 (Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only). Experts suggest coding only one ECG interpretation per session.

Brugada syndrome is a hereditary disease that can cause sudden death due to arrhythmia. If the physician confirms Brugada syndrome, you should report 746.89 (Other specified congenital anomalies of heart).