Ask Dr. Z

Can you help us determine the correct CPT codes, especially for the ablation of the cavotricuspid isthmus? "Pre- and post-op diagnosis is atrial fibrillation. An 8 French ICE catheter was advanced to the right atrium and used to monitor throughout the case... Septum was punctured using a transseptal needle. A PentaRay catheter was inserted into the left atrium, and 3D anatomical and voltage mapping was obtained. Patient was noted to have significant areas of scar anterior posteriorly as well as partial scarring of the pulmonary veins. A Biosense Webster FJ ablation catheter was advanced to the left atrium. Sequential lesions were placed in antral fashion along the left and right veins. After circumferential ablations were completed, the PentaRay catheter was again replaced into the left atrium, and block into the veins was demonstrated. Ablation of cavotricuspid isthmus was undertaken at this time. Sequential lesions were placed from the tricuspid valve to the IVC. Block across the cavotricuspid was demonstrated after ablations were completed, and the block persisted for an appropriate waiting."