Wiki EP physiology Study CPT add on code 93623 Vs 96365 post ablation

[yacovej]

93623 is an add on code used when IV intravenous drug infusion is used for programmed stimulation and pacing at the beginning of a case. One of my physicians is not using IV drug for pacing at the beginning of the case and this cpt code cannot be used to verify the effectiveness of the ablation procedure at the end. So she is using Isubrel at the end of the ablation to see if any arrhythmias can be invoked and now she wants me to bill CPT 96365- for the post ablation to test existing arrhythmias. Does anyone know if this is feasible? I can't find any information on the use of this cpt for Post EP study. I appreciate any help.

 

[twizzle]

CPT 96365 and EP procedures.

93623 is an add on code used when IV intravenous drug infusion is used for programmed stimulation and pacing at the beginning of a case. One of my physicians is not using IV drug for pacing at the beginning of the case and this cpt code cannot be used to verify the effectiveness of the ablation procedure at the end. So she is using Isubrel at the end of the ablation to see if any arrhythmias can be invoked and now she wants me to bill CPT 96365- for the post ablation to test existing arrhythmias. Does anyone know if this is feasible? I can't find any information on the use of this cpt for Post EP study. I appreciate any help.

For starters, 96365 is bundled with (for example) 93656. Also, is your provider documenting the time spent giving the Isuprel because 96365 is a time-based code?
What your provider is trying to do is get paid for something which they have already been paid for. Confirmation of the adequacy of the ablation is included in payment for an ablation procedure so I'm afraid they are incorrect in trying to bill 96365 post ablation. Unbundling is to be discouraged.

 

[yacovej]

Post EP Study cpt code not feesable

I thought that this was incorrect, I tried to explain to her that this code couldn't be used but I needed a more clearer explanation. I appreciate your quick response. Happy New year!

 

[yacovej]

96365

For starters, 96365 is bundled with (for example) 93656. Also, is your provider documenting the time spent giving the Isuprel because 96365 is a time-based code?
What your provider is trying to do is get paid for something which they have already been paid for. Confirmation of the adequacy of the ablation is included in payment for an ablation procedure so I'm afraid they are incorrect in trying to bill 96365 post ablation. Unbundling is to be discouraged.

96365 can be billed with 93656 with a modifier per cci edits. To be clear, She is using isuprel at the end of an EP study to invoke an arrhythmia- and wants to bill 96365 for this reason. I'm not so sure this is acceptable to bill?