Cardioversion CPT Code

2023 | Cardioversion CPT Codes | Description, Guidelines, Reimbursement & Examples

Cardioversion CPT code(s) 92960 or 92961 may be used for service when the physician performs elective cardioversion and electrical conversion of arrhythmia externally or internally. The physician delivers an electrical charge into the heart muscles to stimulate the heartbeat to a different rhythm.

Description Of The Cardioversion CPT Codes

The following are the reasons why the physician performs cardioversion:

  • Atrial fibrillation
  • Atrial flutter
  • Ventricular fibrillation
  • Ventricular tachycardia
  • Atrial tachycardia

The physician gives an electric shock to the patient’s chest to regulate dangerously irregular heartbeats. The electric shock machine consists of two paddles and a defibrillator machine placed by the physician on the patient’s chest or back. 

The determined electric shock administers from the chest to the heart to convert the heartbeat to a regular rhythm—Cardioversion CPT code 92960 bills for external cardioversion and CPT 92961 when the procedure performs internally.

The following are the types of cardioversions:

Electrical Cardioversion: The Physician delivers an electrical shock to the patient’s chest with the help of paddles composed of electrode patches. Suppose the heart is not functioning correctly and is at higher risk of dangerous arrhythmias. The physician may implant an implantable cardioverter-defibrillator (ICD) to stabilize the patient’s heart rhythm. 

Chemical cardioversion: The Physician administers medicine or substance via IV route or swallowed by the patient directly. Correct heart rhythms may take several hours, minutes, or days.  

CPT 92960

Cardioversion CPT code 92960 bills for service when the physician externally performs elective cardioversion and electrical conversion of arrhythmia.

The official description of the 92960 CPT code is: “Cardioversion, elective, electrical conversion of arrhythmia; internal (separate procedure).”

92960 cpt code for cardioversion

CPT 92961

Cardioversion CPT code 92961 bills for service when the physician internally performs elective cardioversion and electrical conversion of arrhythmia.

92960 cpt code for cardioversion

Reimbursement

A maximum of two units can be a billed on the same service date of Cardioversion CPT code(s) 92960 and 92961. In contrast, the three units allow documentation supporting the service’s medical necessity. 

The cost and RUVS of CPT 92960 are $117.68 and 3.40048 when performed in the facility. In contrast, the reimbursement and RUVS of CPT 92960 are $176.23 and 5.09248 when performed in the non-facility.

The cost and RUVS of CPT 92961 are $260.21 and 7.51929 when performed in the facility. In contrast, the reimbursement and RUVS of CPT 92961 are $260.21 and 7.51929 when performed in the non-facility.

Billing Guidelines

It is appropriate to report separately if device evaluation for implantable defibrillator/multi-lead pacemaker system (93282-93284, 93287, 93289, 93295-93296) is performed with CPT 92960 or 92961.

Electrophysiological studies (93618-93624, 93631, 93640-93642) may be used in conjunction with CPT 92960 or 92961, and it is appropriate to report them separately. 

You may report intracardiac ablation (93650-93657, 93662) separately if used with CPT 92960 or 92961.

Billing Examples

The following are five billing examples when cardioversion CPT code(s) 92960 or 92961 can be reported appropriately.

Example 1

A 38-year-old male presents to ED with a chief complaint of dizziness. The patient reports vertigo began one day ago. Vertigo began while at home when he stood up. 

The patient describes the course of vertigo as abrupt, and The dizziness is currently 6/10. Vertigo is worsened by standing, head movement, and movement. The vertigo is not worsened by breathing or lying supine. 

Anti-vertigo meds alleviate vertigo. Vertigo is associated with nausea, vomiting, and gait instability. Vertigo is not associated with a vision change. 

The patient is morbidly obese and has a higher risk of heart disease. The PhysicianPhysician ordered multiple diagnostic tests ECG, CMP, CBC, CT, MRI, and X-ray of the head and spine.

Diagnostic studies show that the patient had an irregular heartbeat and suggested cardioversion.

Example 2

A 30-year-old female with no PMH is coming in for intermittent chest pain exacerbated by left-arm movement but is non-exertional. 

Differential includes, but is not limited to, MSK-related pain/costochondritis/ ACS Pt is very well appearing with routine physical exam and vitals. She is not having any pain right now. Given the positional nature of chest pain, I suspect a musculoskeletal cause. 

The patient was not getting better with medication. Physicians ordered a chest CT and EKG to confirm that the heart was functioning correctly. 

Diagnostic studies show that the patient had an irregular heartbeat and suggested cardioversion.

Example 3

Forty-six-year-old female with PMH of hypertension and a family history of heart disease, heart murmur, LBBB dx 1 year ago, migraines, tested positive for COVID 1 month ago. 

Since yesterday afternoon, she has presented to ED c/o constant lip-tingling, lightheadedness, and left-sided chest discomfort. She woke morning with the same symptoms and developed left upper extremity tingling and bilateral hand tingling. The patient did not get vaccinated for COVID. 

The patient Denies headache, shortness of breath, back pain, abdominal pain, nausea, vomiting, diarrhea, changes in vision, urinary complaints, or any other symptoms. 

The patient has a family history of heart diseases—the physician plan to do labs, EKG, X-ray, CT, and chest MRI.

Diagnostic studies show that the patient had an irregular heartbeat and suggested a Holter monitor for 24 hours.

Example 4

A 27-year-old male with PMH Systolic/Diastolic CHF (EF <15% 7/23/21, s/p AICD), COVID x2, s/p TAVR, CAD, CKD, PAD, hypothyroidism for shortness of breath. He has developed progressively worsening shortness of breath for four days. 

He noticed worsening SOB lying on his right side and with exertion. He takes his vitals daily and weighs himself daily. 

He typically weighs 171 lbs but has seen a 3.5lb increase to 174.5 lbs over this past week, prompting him to take one dose of alprazolam 30mg. He noticed a minimal improvement in his symptoms with the alprazolam. 

When he has episodes of coughing with phlegm, he notices a substernal discomfort. The discomfort is not alleviated with rest and not exacerbated with exertion. He has also noticed increasing yellow phlegm production, cough, nasal congestion, and rhinorrhea. 

The physician has respiratory problems along with Heart issues. Diagnostic studies show that the patient had an irregular heartbeat and suggested cardioversion. The physician ordered EKG, Labs, CT, and MRI to diagnose for further treatment.

Example 5

A 39-year-old female presented office for dizziness, weakness, and tingling in the upper extremity. The patient denies any abdominal pain, diarrhea, vomiting, or headache in the system review. 

A physical exam revealed that the patient had an irregular heartbeat, shortness of breath, and fluid accumulation in the upper extremity, more likely edema. A physical exam strongly suggests ruling out heart-related diseases. The physician decides to do an ECG/EKG, CTA, and MRA of the chest. 

Diagnostic studies show that the patient had an irregular heartbeat and suggested cardioversion. EKG revealed that the patient is tachycardic. The physician consulted with the cardiologist for further treatment of the patient.

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