Cardiology Coding Alert

Question: My physician attempted an atrioventricular (AV) node ablation but was unsuccessful. The ablation was performed, but the patient continued to be able to be induced into PSVT (paroxysmal supraventricular tachycardia). He abandoned the ablation attempts because he determined the patient was at risk of being induced into a third-degree AV block. Should I bill this with modifier -52 (Reduced services)?

Texas Subscriber

Answer: No. There is a difference between a reduced service and an unsuccessful procedure. In this case, the cardiologist was able to complete the procedure. Even though the outcome was not what was hoped for, this matters little from a coding and reimbursement standpoint. Therefore, modifier -52 is not necessary and should not be appended to 93650 (Intracardiac catheter ablation or atrioventricular node function, atrioventricular conduction for creation of complete heart block, with or without temporary pacemaker placement) unless the cardiologist is unable to complete all of the components of the procedure.

Answers for You Be the Coder and Reader Questions were provided by Marko Yakovlevitch, MD, FACP, FACC, a cardiologist in private practice in Seattle; Sandy Fuller, CPC, a cardiology coding and reimbursement specialist in Abilene, Texas; and Nikki Vendegna, CPC, a cardiology coding and reimbursement specialist in Overland Park, Kan.