Cardiology Coding Alert

Question: My cardiologist inserted multiple catheter electrodes into the patient using fluoroscopic guidance. He passed catheter electrodes from the femoral veins into the right atrium, His bundle, and right ventricle. He connected the catheters to an electrical pacing device, which transmitted electrical impulses to the atrium and ventricle. The electrodes at the tip of the catheter recorded the heart’s electrical activity in the right atrium, ventricle, and His bundle. The cardiologist also attempted to induce an arrhythmia. Should I report 93620 or 93619 for this procedure?

Tennessee Subscriber

Answer: You should report 93620 (Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with right atrial pacing and recording, right ventricular pacing and recording, His bundle recording) for this procedure.

Don’t miss: You would choose 93620 instead of 93619 (Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, His bundle recording, including insertion and repositioning of multiple electrode catheters, without induction or attempted induction of arrhythmia) in this case because your cardiologist attempted to induce an arrhythmia.

Codes 93619 and 93620 are both comprehensive electrophysiologic (EP) study codes. You should always this checklist to make sure the medical documentation supports that the cardiologist performed the five following services if you report 93619 and 93620:

• Right atrial recording
• Right atrial pacing
• Right ventricular pacing
• Right ventricular recording
• Bundle of His recording

If the medical documentation is not reflective of the above components, then coders should report each component individually based on the specific procedure that the cardiologist performed and documented. You would do this by using the following limited EP study codes: 93600 (Bundle of His recording)-93603 (Right ventricular recording), 93610 (Intra-atrial pacing), 93612 (Intraventricular pacing), and 93618 (Induction of arrhythmia by electrical pacing).