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CODING and REIMBURSEMENT for ELECTROPHYSIOLOGY Physician1

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CODING and REIMBURSEMENT for ELECTROPHYSIOLOGY Physician1 INTRO PHYSICIAN PHYSICIAN COMMON HOSPITAL HOSPITAL HCPCS DIAGNOSIS CODING ADD-ON CODES SCENARIOS OUTPATIENT INPATIENT C-CODES CODES ABBOTT CODING GUIDE ELECTROPHYSIOLOGY Effective January 1, 2019 References 1 INTRO PHYSICIAN PHYSICIAN COMMON HOSPITAL HOSPITAL HCPCS DIAGNOSIS CODING ADD-ON CODES SCENARIOS OUTPATIENT INPATIENT C-CODES CODES ELECTROPHYSIOLOGY Effective January 1, 2019 Introduction Disclaimer The Electrophysiology Coding Guide is intended to provide reference This document and the information contained herein is for general material related to general guidelines for the reimbursement of information purposes only and is not intended and does not constitute the Electrophysiology procedures when used consistently with legal, reimbursement, coding, business or other advice. Furthermore, the products' labeling. This guide includes information regarding it is not intended to increase or maximize payment by any payer. coverage, coding and payment . Nothing in this document should be construed as a guarantee by Abbott regarding levels of reimbursement, payment or charge, or that reimbursement or other payment will be received. Similarly, nothing in this document should be viewed as instructions for selecting any Reimbursement Hotline particular code. The ultimate responsibility for coding and obtaining In addition, Abbott offers a reimbursement hotline, which provides payment/reimbursement remains with the customer. This includes live coding and reimbursement information from dedicated the responsibility for accuracy and veracity of all coding and claims reimbursement specialists. Coding and reimbursement support is submitted to third-party payers. Also note that the information available from 8 a.m. to 5 p.m. central time, Monday through Friday at presented herein represents only one of many potential scenarios, (855) 569-6430. This guide and all supporting documents are available based on the assumptions, variables and data presented. In addition, at https://www.cardiovascular.abbott/us/en/hcp/reimbursement/ the customer should note that laws, regulations, coverage and electrophysiology.html. Coding and reimbursement assistance is coding policies are complex and updated frequently. Therefore, the provided subject to the disclaimers set forth in this guide. customer should check with their local carriers or intermediaries often and should consult with legal counsel or a financial, coding or reimbursement specialist for any coding, reimbursement or billing questions or related issues. This information is for reference purposes only. It is not provided or authorized for marketing use. References 2 INTRO PHYSICIAN PHYSICIAN COMMON HOSPITAL HOSPITAL HCPCS DIAGNOSIS CODING ADD-ON CODES SCENARIOS OUTPATIENT INPATIENT C-CODES CODES PAGE 1 PAGE 2 PAGE 3 PAGE 4 CODING AND REIMBURSEMENT FOR ELECTROPHYSIOLOGY Physician1 Electrophysiology studies are invasive diagnostic intracardiac procedures performed to assess patients' cardiac arrhythmias. Comprehensive Electrophysiology Evaluations include the following: • Insertion and repositioning of electrode catheters • Right atrial pacing and recording • Right ventricular pacing and recording • His Bundle recording • Induction or attempted induction of arrhythmia (in most circumstances) CPT‡ DESCRIPTION WORK NATIONAL MEDICARE RATE CODE RVU FACILITY NON FACILITY COMPREHENSIVE ELECTROPHYSIOLOGY STUDIES Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right 93619 ventricular pacing and recording, His bundle recording, including insertion and repositioning of 7.06 $410 $410 multiple electrode catheters, without induction or attempted induction of arrhythmia Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple 93620 electrode catheters with induction or attempted induction of arrhythmia; with right atrial pacing 11.32 $659 $659 and recording, right ventricular pacing and recording, His bundle recording Electrophysiologic follow-up study with pacing and recording to test effectiveness of therapy, 93624 4.55 including induction or attempted induction of arrhythmia $254 $254 Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple +93621 electrode catheters with induction or attempted induction of arrhythmia; with left atrial pacing 2.10 $122 $122 and recording from coronary sinus or left atrium Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple +93622 electrode catheters with induction or attempted induction of arrhythmia; with left ventricular 3.10 $181 $181 pacing and recording (+) = Indicates add-on code. List add-on code separately in addition to code for primary procedure. The -26 modifier may be applicable for a number of these codes. It is incumbent upon the physician to determine which, if any modifiers should be used first. Effective Dates: January 1, 2019 - December 31, 2019 References 3 INTRO PHYSICIAN PHYSICIAN COMMON HOSPITAL HOSPITAL HCPCS DIAGNOSIS CODING ADD-ON CODES SCENARIOS OUTPATIENT INPATIENT C-CODES CODES PAGE 1 PAGE 2 PAGE 3 PAGE 4 CODING AND REIMBURSEMENT FOR ELECTROPHYSIOLOGY Physician1 Electrophysiology Study (EP) component codes should be used when all elements in a comprehensive code are not performed and/or documented. (List below is not all inclusive.) CPT‡ DESCRIPTION WORK NATIONAL MEDICARE RATE CODE RVU FACILITY NON FACILITY INDIVIDUAL STUDIES* 93600 Bundle of His recording 2.12 $124 $124 93602 Intra-atrial recording 2.12 $122 $122 93603 Right ventricular recording 2.12 $122 $122 93610 Intra-atrial pacing 3.02 $172 $172 93612 Intraventricular pacing 3.02 $170 $170 MAPPING & ADD-ON PROCEDURES (List separately in addition to code for primary procedure.) Intraventricular and/or intra-atrial mapping of tachycardia site(s) with catheter manipulation to +93609 4.99 record from multiple sites to identify origin of tachycardia $292 $292 +93613 Intracardiac electrophysiologic 3-dimensional mapping 5.23 $311 $311 +93623 Programmed stimulation and pacing after intravenous drug infusion 2.85 $166 $166 (+) = Indicates add-on code. List add-on code separately in addition to code for primary procedure. The -26 modifier may be applicable for a number of these codes. * Component (e.g., individual study) codes cannot be billed in conjunction with comprehensive EP codes It is incumbent upon the physician to determine which, if any modifiers should be used first. Effective Dates: January 1, 2019 - December 31, 2019 References 4 INTRO PHYSICIAN PHYSICIAN COMMON HOSPITAL HOSPITAL HCPCS DIAGNOSIS CODING ADD-ON CODES SCENARIOS OUTPATIENT INPATIENT C-CODES CODES PAGE 1 PAGE 2 PAGE 3 PAGE 4 CODING AND REIMBURSEMENT FOR ELECTROPHYSIOLOGY Physician1 Catheter Ablation CPT‡ codes include Comprehensive EP studies. CPT‡ DESCRIPTION WORK NATIONAL MEDICARE RATE CODE RVU FACILITY NON FACILITY CATHETER ABLATION Intracardiac catheter ablation of atrioventricular node function, atrioventricular conduction for creation 93650 10.24 of complete heart block, with or without temporary pacemaker placement $620 NA Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of an arrhythmia with right atrial pacing and recording, right ventricular pacing and recording (when necessary), and His bundle recording (when necessary) 93653 14.75 with intracardiac catheter ablation of arrhythmogenic focus; with treatment of supraventricular $878 NA tachycardia by ablation of fast or slow atrioventricular pathway, accessory atrioventricular connection, cavo-tricuspid isthmus or other single atrial focus or source of atrial re-entry Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of an arrhythmia with right atrial pacing and recording, right ventricular pacing and recording (when necessary), and His bundle recording (when necessary) 93654 19.75 with intracardiac catheter ablation of arrhythmogenic focus; with treatment of ventricular tachycardia or $1,175 NA focus of ventricular ectopy including intracardiac electrophysiologic 3D mapping, when performed, and left ventricular pacing and recording, when performed Intracardiac catheter ablation of a discrete mechanism of arrhythmia which is distinct from the primary +93655* 7.50 ablated mechanism, including repeat diagnostic maneuvers, to treat a spontaneous or induced arrhythmia $447 NA Comprehensive electrophysiologic evaluation including transseptal catheterizations, insertion and repositioning of multiple electrode catheters with induction or attempted induction of an arrhythmia 93656 including left or right atrial pacing/recording when necessary, right ventricular pacing/recording 19.77 $1,178 NA when necessary, and His bundle recording when necessary with intracardiac catheter ablation of atrial fibrillation by pulmonary vein isolation Additional linear or focal intracardiac catheter ablation of the left or right atrium for treatment of atrial +93657 7.50 fibrillation remaining after completion of pulmonary vein isolation $446 NA (+) = Indicates add-on code. List separately in addition to code for primary procedure. The -26 modifier may be applicable for a number of these codes. * 93655 has a medically unlikely edit (MUE) of 2 units. Ablation codes 93653, 93654, and 93656 do not require a modifier -52. It is incumbent upon the physician to determine which, if any modifiers should be used first. NA: There
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