Cardiology Coding Alert

Question: My cardiologist performed a comprehensive electrophysiologic (EP) study, which included the insertion and repositioning of multiple electrode catheters. They also performed right atrial pacing and recording, right ventricular pacing and recording, His bundle recording. Additionally, my cardiologist attempted to induce an arrhythmia. Which code should I report on my claim?

Maine 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) on your claim.

Don’t miss: Code 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) is also a comprehensive EP code. The only difference between codes 93619 and 93620 is whether the induction for arrhythmia is performed during the study. Code 93619 is without induction or attempted induction, and code 93620 is with induction or attempted induction.

EP study defined: An EP study is a test performed to assess the heart’s electrical system/activity and is used to diagnose abnormal heartbeats or arrhythmias. This test is usually performed by inserting specialized catheters and then wire electrodes, which measure the electrical activity through the blood vessels that enter the heart.

When the conduction of the electrical activity of the heart is not synchronized due to the normal pathways being interrupted by infarct and scarring, irregular and asynchronous electrical conduction can occur. Over time, new pathways may be created, which causes abnormal heart rhythms like atrial fibrillation, atrial flutter, supraventricular tachyarrhythmia (SVT), and ventricular tachycardia.

Recording and mapping of the conduction system allows the cardiologist to identify any electrical impulse abnormalities causing this arrhythmia. From that, they will be able to determine and provide appropriate treatment options. This treatment is often an interruption of the abnormal pathway, by ablating the pathway with radiofrequency (heat) or cryo (cool) ablation catheters.