Ask Dr. Z

Do you have any guidance on how to bill 4D ICE imaging performed during Watchman procedure? The patient also had 93656 and 93655 performed, but there was no mention of 4D ICE used during that portion of the procedure. I copied portions of the Watchman that mention the 4D ICE below.

“The 4D ICE was then placed in the LA with fluoro. Catheter was advanced through the Watchman sheath. Catheter was maneuvered into the left atrial appendage, and contrast injections were performed for positioning of the Watchman sheath. 4D ICE images were reviewed along with contrast injections. The device and passed the anchor or tug-test under ICE and fluoroscopic visualization. When measured in multiple 4D ICE views, compression was measured at 20%.”