Wiki 93655/93657

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mariecass

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Can someone explain how to use these codes correctly?

CPT 93655 if the Patient has VT ablation and SVT ablation after a PV Isolation would you report :
93656-PV Isolation
93655-VT ablation
93655-SVT ablation

CPT 93657 if the Patient has additional Afib after a PV Isolation would you report:
93657 for each additional linear ablation done for atrial fib or can you only report it once no matter how many additional linear ablations are done for afib?

Thanks!
confused:
 
You can report 93657 for each additional linear ablation. CPT has not limited this code. If the documentation is clear of each additional ablation, then you can code it. That's one way physicians could make up lost RVU from bundling, when medically necessary, of course.

Same with 93655 - no limit as long as there is clear documentation.
 
I agree with Jewlz, You can report +93657 for each additional linear ablation done for AFIB after the primary PVI. If there is a separate and distinct mechanism(s) say VT/SVT you would use +93655, which can also be used more than once if documented.
 
93655/93657-additional help

Just so I am understanding correctly:

So if you do a PV isolation (93656) and the 2 additional linear lesions for Afib you would bill 93657 twice?

Also, if you do a PV isolation (93656) and then do a atrial tachycardia ablation and a atrial flutter ablation you would bill 93655 twice (once for the atrial tachycardia, and once atrial flutter?)


I had a patient that had 3 different ablations done after the PV isolation, but it was all for atrial flutter so I was told by a expert coder that you would only bill 93655 once because it was all atrial flutter?

Thanks so much for answering.
 
Last edited:
That is correct. You'll need a 59 on the additional add-on codes so the ins co knows that they are different ablations.

If the physician describes the arrhythmia's as distinct and separate lesions to ablate then you can bill for both; 93655 x2.

That is my understanding. I have listened to a few webinars and I have not heard what your coding expert mentioned but since these are new codes and we have yet to see how the ins companies will recieve them, I suppose there could be future direction of this nature. But for now, it is my understanding we can bill for each, when documented.
 
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