Ask Dr. Z

Is this enough to code 93657? "There was evidence of recovery into the upper PVs and the posterior LA wall.PV potentials were blunted. A 4-pole irrigated contact force tip ablation catheter was advanced into the LA. 3-D mapping with the NAVX system was used to create a model of the LA and PV's. The left PV's isolated with relative ease (wide posterior ablation).The RIPV posteriorly directed was very challenging. To isolate the RSPV, Ablation was extended onto the roof and septal aspect. Ablation was necessary on the posterior carina. Isolation was confirmed with bidirectional block into each PV.Burst pacing was performed in attempt to induce atrial flutter. This induced an atrial flutter (CL 300 ms - earliest activation on CS1,2). Entrainment from CS1 ,2 -- yielded a PPI 70 ms. Thereafter the flutter degraded into AFIb with variable LC and activation.This was cardioverted.Attempt to reinduce AFL continuous yielded AFib. Additional ablation was done along the roof."