Thursday, January 03, 2013

To EPs: Happy Coding New Year!

Well, well, well.  It's another year and another chance to enjoy new procedural coding changes for electrophysiologists in 2013!  In case you missed it, the old catheter ablation codes for supraventricular and ventricular tachycardia ablations (93651 and 93652) have been deleted effective 1 Jan 2013.

That's right:  Gone.  Kaput.  Fi-ne. 

In their place we now have five new codes, two of which are specific for atrial fibrillation ablation:

  • 93653 - For use with SVT/WPW/Focal ATach/IVC-Tricuspid annular-dependent flutter ablations - Don't even THINK about coding separately for transseptal catheterization with this one - it's now bundled.  (If 3D mapping is needed, it looks like it's still okay to add 93613 to this code - for now.  Also, for Afib ablations, do NOT use this code, but rather a separate code (See 93656 and 93657 below)). RVU Value: 15.

  • 93654 - For use with Ventricular Tachycardia Ablation - This includes everything from placement of catheters, to the transseptal (if needed), AND the use of 3D mapping, and the ablation of VT.  (Remember: no separate code of transeptal and 3D mapping with this code.) RVU Value: 20.

    • If there is a SECOND arrhythmia focus that is ablated during EITHER SVT or VT ablation codes above, you can use add-on code 93655 but must specify the second arrhythmia targeted.  Total RVU value: 7.5
  • 93656 - For use with Atrial Fibrillation ablations - This includes the placement of catheters, the transseptal, pacing, mapping, giving meds, etc. up to and including isolation of the pulmonary veins.   (It appears 3D mapping (93613) can be billed separately for this code, unlike for the VT ablation)Total RVU value: 20.02.

    • 93657 - Used in addition to the Afib ablation code, 93656, if linear lines are developed in the atria following pulmonary vein isolation procedure. Total RVU value 7.5
Full details on these new codes, how they were developed, and how they should (really) be applied can be found on the Heart Rhythm Society website. (Please take what I say with a grain of salt).

Happy coding!



Steve Parker, M.D. said...

My understanding is that the American Medical Association makes a substantial amount of money selling their code books. Makes sense for them to change the codes frequently. I'm sorry that highly trained healthcare professionals have to spend time learning the codes instead of caring for patients.


Anonymous said...

I finished my EP fellowship a couple of years ago, and I'm in private practice, never saw the big money... the cuts are unbelievable, around 30 % when you take bundle into account... not sure how much longer we will be able to take this for... we are being pushed around way too far...