Cardiology Question for the Week of July 17, 2017

Cardiology Compliance Question of the Week

Question:

Can we bill the following code more than once for each additional linear ablation performed, or is there a limit to once per session?

93657 Additional linear or focal intracardiac catheter ablation of the left or right atrium for treatment of atrial fibrillation remaining after completion of pulmonary vein isolation (List separately in addition to code for primary procedure).

Answer:

As shown below, CPT Assistant, July 2013, states that 93657 can only be reported once per operative session.  In addition, Medicare has a medically unlikely edit (MUE) of “1” for 93657.

Question: With the new EP ablation add-on codes 93655, Intracardiac catheter ablation of a discrete mechanism of arrhythmia which is distinct from the primary ablated mechanism, including repeat diagnostic maneuvers, to treat a spontaneous or induced arrhythmia (List separately in addition to code for primary procedure), and 93657, Additional linear or focal intracardiac catheter ablation of the left or right atrium for treatment of atrial fibrillation remaining after completion of pulmonary vein isolation (List separately in addition to code for primary procedure), may these codes be reported more than once per discrete mechanism or line, or are the codes reported only once per encounter?

Answer: If performed, code 93655 may be reported more than once during the same operative session. However, code 93657 can only be reported once per operative session.

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.