92950=Cardiopulmonary resuscitation (CPR) is a manual attempt at restarting a patient's heart and lungs when cardiopulmonary arrest occurs. Typically led by a health care provided certified in CPR, the lungs are filled with air by holding the nose and breathing throught the mouth or performed with a ventilating bag. Chest compressions are also performed at intervals, alternating with the the air in the lungs. A defibrillator may be used to shock the heart into starting.
92960=External cardioversion, in which a defibrillator's paddles are placed on a patient's chest and regular electrical pulses used to regulate the heartbeat. Code 92961 for an internal procedure.
My first thought was 92960; however, CPT Assistant has a couple of articles relating to this service suggesting otherwise. Excerpt from June '93...
Code 92960 is used to report the physician services related to the elective cardioversion as described in this article. There is no separate CPT code to use to report defibrillation. Although both procedures shock the heart to alter its rhythm, elective cardioversion is a planned event; defibrillation is performed as an emergency measure and is generally part of the care provided during a medical emergency such as cardiac arrest/ventricular fibrillation or is an integral part of another procedure, such as cardiac surgery.
Nov. 2000...
CPT codes 92960 and 92961 are used to report cardioversion. Code 92960 specifically describes elective (nonemergency) external electrical cardioversion. Elective cardioversion is most often used to treat atrial fibrillation and atrial flutter if anti-arrhythmic drugs fail to convert the heart back to normal sinus rhythm, or if the patient is hemodynamically unstable. The electric shock given in cardioversion is synchronized (ie, timed to occur during the R wave of the electrocardiogram). The patient will have his/her heart rhythm monitored for several hours after the procedure to ensure the rhythm remains stable.
Questions are often raised regarding use of the cardioversion codes to report defibrillation. Defibrillation is the delivery of an electrical impulse to the heart. This impulse is intended to interrupt life-threatening abnormal rhythms (eg, ventricular fibrillation, pleiomorphic ventricular tachycardia or ventricular tachycardia associated with shock) and allow the normal sinus impulse and electrical conduction to resume. The electrical impulse must be strong enough to cause depolarization (neutralization of the positive and negative electrical charges) of a large percentage of the myocardium. The timing of the defibrillation shock is not synchronized to the cardiac cycle (ie, it is not delivered during an R wave).
There is no CPT code to report defibrillation as a procedure performed in isolation. Defibrillation may be performed as part of critical care services, at the end of open heart surgery, during cardiac catheterization and coronary angiography, or during an electrophysiological procedure. Defibrillation is often a component of cardiac resuscitation, especially in adults. In all of these situations, defibrillation is not a separately reportable service.