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ED Coding and Reimbursement Alert

You Be the Coder:

Don't Be Shocked; Is This Cardioversion or Defibrillation?

Published on Thu Jan 20, 2011

Question: How would you code the following scenario? A78 year-old-male presents to the ED after suffering cardiac arrest. The medics had regained vital signs initially in route to the hospital but upon entering the ED, the patient "codes". The initial rhythm is noted to be ventricular fibrillation. The patient is defibrillated several times with escalating levels of electricity, and upon the 3rd attempt converts to normal sinus rhythm. At this point, the patient is intubated and rushed to the cardiac cath lab.Answer: Sounds like you have defibrillation rather than cardioversion. According to the AMA CPT® Assistant, "Although cardioversion and defibrillation are both ways of shocking the heart to alter its rhythm, they are two distinctly different procedures. Defibrillation is the delivery of an electrical impulse to the heart. This impulse is intended to interrupt abnormal rhythms (e.g., ventricular fibrillation) and allow the normal sinus impulse and electrical conduction to resume."There is no [...]
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