Ask Dr. Z

We struggle with understanding when code 93655 can be used and when it cannot be used. Our provider indicated that he did two ablations; the first was for “Atypical Narrow QRS AVNRT (slow-slow) located in the lower 1/3 of the triangle of Koch and terminated through cryothermal ablation”. After being observed for 30 minutes, repeat testing resulted in a second ablation of “Orthodromic Narrow QRS AVRT (induction CS pacing off isuprel [burst and LAESS]) located in the mitral annulus - left lateral that was terminated through radiofrequency ablation” and is referred to as an “accessory pathway”. The provider documented SVT as the diagnosis with indentations separately identifying AVRT and AVNRT. Do the two different locations and the designation of being an “accessory pathway” qualify this as a distinct arrhythmia (93655)?