Cardiology Coding Alert

Question: Can I bill for a ventricular stimulation and right ventricle recording with the induction of arrhythmia? If so, would I report 93603-26, 93612-26 and 93618-26? I was told that these codes are bundled into the electrophysiology (EP) study, but we didn't do an EP study.

Rhode Island Subscriber

Answer: The codes you list are for pacing and recording in the ventricle, as well as induction or attempted arrhythmia induction. The fact that your electrophysiologist did not perform a comprehensive EP study would obligate you to bill for the individual EP components. Based on the information you provide, your coding is accurate.

The comprehensive EP study codes are:

• 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

• 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.

Specifically, you should report 93619 only if the physician performs and documents each of the five components of a comprehensive EP study. These component services include recording from the atrium (93602, Intra-atrial recording), bundle of His (93600, Bundle of His recording), and the ventricle (93603).

Code 93619 also includes pacing from the atrium (93610, Intra-atrial pacing) and the ventricle (93612, Intraventricular pacing). Code 93620 includes all of these services, plus induction or attempted arrhythmia induction (93618).

Bottom line: When the physician provides less than the comprehensive study (93619 or 93620), you should report the subcomponents that the physician provides and documents.