Ask Dr. Z

When coding for EP studies/ablations, is it appropriate to assign ICD-10-CM codes for provoked arrhythmias?

Example 1: Patient presents for successful ablation of SVT. Should AV block be coded from the following?

“There were no inducible arrhythmias with ventricular pacing protocol. Adenosine 9 mg resulted in AV block with no ventricular pre-excitation but eccentric VA activation persisted”

Example 2: Patient presents for ablation of ventricular preexcitation, none was found. AV/VA block and RBBB noted as below. Should these be coded separately?

“Ventricular extrastimulus was performed with no inducible arrhythmias or eccentric VA conduction. Adenosine 12 mg was administered resulting in both AV and VA block with no ventricular pre-excitation. There was intermittent junctional rhythm at baseline. There was development of right bundle branch block due to His/RVA catheter. There were intermittent wide complex beats noted during atrial pacing that were found to be due to His/RVA catheter movement.”