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Electrophysiologic procedures - ASA '00537'

Phyllis Posted Tue 17th of September, 2013 14:51:23 PM

The patient received a biventricular ICD upgrade. CPT '33249' was given by the anesthesiologist, which crosses to ASA '00537'. However, the Cardiology/EP note states, "Ventricular fibrillation induction and defibrillation threshold testing were deferred." Since induction and testing were deferred, can we use ASA '00537'? If not, what CPT/ASA would you recommend?

SuperCoder Answered Tue 17th of September, 2013 19:49:04 PM

My Senior Editor will answer this soon.

Thanks

SuperCoder Answered Tue 17th of September, 2013 19:50:00 PM

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SuperCoder Answered Tue 17th of September, 2013 19:50:00 PM
With Apoorba
SuperCoder Answered Wed 18th of September, 2013 04:15:26 AM

Answered to Amit through email, on 09/18 IST 1.40 pm.

SuperCoder Answered Wed 18th of September, 2013 09:39:48 AM

This depends on the OP notes and anesthesiologist's notes. If the deferring decision had been taken before induction of anesthesia and only the anesthesia for ICD upgradation was given, then CPT code will vary. If that's the case, anesthesia was given for skin-level surgery (implantation/upgrade of ICD) and based on the CPT code, 00400 anesthesia code could be correct.
But if the anesthesia was given for electrophysiologic testing + upgrade of ICD, and later (probably after ICD placement) it was decided to defer the testing, then reportable CPT code would be different. In that case, since anesthesiologist had already inducted anesthesia for EP testing +ICD upgrade, based on choice of CPT code (to be reported by surgeon), the anesthesia code could be 00537.

As per RVG - 00537 code suggests "Includes anesthetic management for electrophysiologic testing of cardioverter-defibrillators".

Since anesthesia for a surgery is given only once, choice of anesthesia code would depend on the extent & level of anesthesia provided. So I would suggest to check with the surgeon and anesthesiologist for what purpose (or for what extent) anesthesia was provided and then to choose the ASA code accordingly.

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