Cardiology Coding Alert

Louisiana Subscriber

Answer: Because the EP ablated an atrioventricular accessory pathway, you should report 93651 (Intracardiac catheter ablation of arrhythmogenic focus; for treatment of supraventricular tachycardia by ablation of fast or slow atrioventricular pathways, accessory atrioventricular connections or other atrial foci, singly or in combination).

Remember: You'll use ablation codes only once, regardless of the number of ablations the physician performs at a specific site, CPT guidelines instruct.

For instance, if the physician ablates more than one area of the supraventricular region, you should still report 93651 only once. CMS factors the possibility of the physician ablating more than one pathway into the relative value units for 93651.

Because the EP performed the diagnostic study at an earlier encounter, you should not report a separate electrophysiology study code for this ablation encounter. But if the report supports 2D (+93609, Intraventricular and/or intra-arterial mapping of tachycardia site[s] with catheter manipulation to record from multiple sites to identify origin of tachycardia [List separately in addition to code for primary procedure]) or 3D (+93613, Intracardiac electrophysiologic 3-dimensional mapping [List separately in addition to code for primary procedure]) mapping make sure to report it, as well.

ICD-9: You should report the paroxysmal supraventricular tachycardia using 427.0 (Paroxysmal supraventricular tachycardia). And 426.7 (Anomalous atrioventricular excitation) is appropriate for the Wolff-Parkinson-White syndrome.