Ask Dr. Z

What statement needs to be in a procedure report to code 93657 now that the physician no longer needs to state additional ablations were performed due to continuing Afib after PV isolation? CPT Assistant Nov 2020 stated 93657 could be coded for patients diagnosed with persistent Afib whether in fibrillation or sinus rhythm at the time of treatment. They stated, "Ablation of fractionated potentials or linear lesions as adjunctive therapy for Afib should be documented, when performed." Patient with persistent Afib. A 3D map of the LA and PVs in Afib rhythm showed conduction into 4 PVs and scar on posterior wall. Wide antral circumferential ablation around LSPV, LIPV, RSPV, RIPV, resulting in electrical isolation. The report states, "Roof line and floor line ablations were performed resulting in posterior wall isolation. The patient remained in AF after ablation, so DCCV with 360J was performed resulting in conversion to sinus rhythm." Code 93657 x 2 or does the physician now need to specifically state the linear lesions were "adjunctive therapy" for Afib?