Ask Dr. Z

Our physician brought a patient in for atrial tachycardias and paroxysmal atrial fibrillation. He starts out with Afib ablation (93656), then states, "Following a period of observation, all pulmonary veins were remapped and were persistently electrically isolated." The patient was then given adenosine with no evidence of acute reconnection. The physician chose to look for SVT. Isuprel was given. The patient developed an artial tachycardia, which quickly transitioned to atrial fibrillation. Isuprel was stopped. Cardioversion was unsuccessful. A series of ablation were performed around the SVC. I chose 93657, but my co-worker is saying it would be 93655 because the rhythm started as SVT. What are your thoughts?