Ask Dr. Z

"Patient with AF burden 5-10% on most recent event monitor, also atrial aflutter (recent EKG), presents for PVI/CTI. The left pulmonary veins were circumferentially encircled as a pair. Adenosine was given within the left superior vein, and a PV reconnection was seen, suggesting breakthrough at the carina. Additional lesions were given in the carina and on the posterior aspect of the left superior vein. Adenosine was given again in the left superior vein and no PV reconnection was seen. The right superior and inferior veins were circumferentially encircled as a pair. Pulmonary vein isolation was performed until there was no further evidence of atrial activation within the veins. Adenosine was given and no PV reconnection was seen. The catheter was withdrawn into the right atrium into the cavotricuspid isthmus. A CTI line was created. Pace-testing confirmed block." Aside from 93656, should I report also 93655 (since atrial flutter was mentioned on history), 93657 (breakthrough at the carina), and 93623?