ED Coding and Reimbursement Alert

Question: Our ED physician used cardioversion/defibrillation on a patient in cardiac arrest. Which code describes this service?

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Answer: The answer depends on which service was performed, since cardioversion is not the same thing as defibrillation. During defibrillation, electric shock is used to restart or normalize heart rhythms. Cardioversion, on the other hand, is the conversion of one cardiac rhythm to another or electrical pattern, usually an abnormal one to normal.

Once you’ve distinguished between cardioversions and defibrillation, then the coding comes easily.

Take note: Defibrillation doesn’t have a specific CPT^® code. If the physician performs defibrillation, that work is bundled into the critical care code 99291 (Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes) or CPR code 92950 (Cardiopulmonary resuscitation [e.g. in cardiac arrest]). If, on the other hand, the documentation suggests that cardioversion was performed, you’ll typically report 92960 (Cardioversion, elective, electrical conversion of arrhythmia; external).