How To Use CPT Code 93657

CPT 93657 describes the additional linear or focal intracardiac catheter ablation of the left or right atrium for the treatment of atrial fibrillation remaining after completion of pulmonary vein isolation. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 93657?

CPT 93657 can be used to describe the additional intracardiac catheter ablation procedure performed on the left or right atrium to treat atrial fibrillation that persists after the completion of pulmonary vein isolation. This code is used when the provider uses radiofrequency energy to create scarring and block the abnormal signals causing the irregular heartbeat.

2. Official Description

The official description of CPT code 93657 is: ‘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).’ This code should be used in conjunction with the primary procedure code for the ablation.

3. Procedure

1. Following the completion of pulmonary vein isolation, the provider prepares the patient and administers anesthesia.
2. The provider then performs additional intracardiac catheter ablation using radiofrequency energy in the left or right atrium to treat the remaining atrial fibrillation.
3. During the procedure, the provider may use linear ablation along a line or focal ablation directed at a specific spot to create scarring and block the abnormal signals causing the irregular heartbeat.
4. After completing the ablation, the provider removes the catheters and all instruments used and applies pressure to the wounds.

4. Qualifying circumstances

CPT 93657 is used when the patient has undergone pulmonary vein isolation and still has atrial fibrillation that requires additional treatment. The provider must perform the ablation in the left or right atrium using radiofrequency energy. This procedure is typically performed by a cardiologist or electrophysiologist who specializes in cardiac rhythm disorders.

5. When to use CPT code 93657

CPT code 93657 should be used when the provider performs additional intracardiac catheter ablation in the left or right atrium to treat atrial fibrillation that remains after pulmonary vein isolation. This code should only be reported in conjunction with the primary procedure code for the ablation.

6. Documentation requirements

To support a claim for CPT 93657, the provider must document the following information:

• Confirmation of the completion of pulmonary vein isolation
• Specific details of the additional ablation procedure performed, including the location (left or right atrium) and the technique used (linear or focal ablation)
• Date of the procedure
• Start and end time of the procedure
• Any complications or adverse events that occurred during the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 93657, ensure that the procedure is performed as an additional treatment following pulmonary vein isolation. This code should be reported in addition to the primary procedure code for the ablation. It is important not to report CPT 93657 without an appropriate code for the primary procedure. Follow the specific guidelines provided by the payer for accurate and timely reimbursement.

8. Historical information

CPT 93657 was added to the Current Procedural Terminology system on January 1, 2013. There have been no updates or changes to the code since its addition.

9. Examples

1. A cardiologist performs additional intracardiac catheter ablation in the left atrium to treat atrial fibrillation that remains after pulmonary vein isolation.
2. An electrophysiologist uses radiofrequency energy to perform focal ablation in the right atrium for a patient with persistent atrial fibrillation following pulmonary vein isolation.
3. A patient undergoes linear ablation in the left atrium by a cardiac electrophysiologist to treat atrial fibrillation that persists after pulmonary vein isolation.
4. A cardiologist performs additional intracardiac catheter ablation in the right atrium using radiofrequency energy to treat atrial fibrillation that remains after pulmonary vein isolation.
5. An electrophysiologist performs focal ablation in the left atrium for a patient with persistent atrial fibrillation following pulmonary vein isolation.
6. A patient undergoes linear ablation in the right atrium by a cardiac electrophysiologist to treat atrial fibrillation that persists after pulmonary vein isolation.
7. A cardiologist performs additional intracardiac catheter ablation in the left atrium using radiofrequency energy to treat atrial fibrillation that remains after pulmonary vein isolation.