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93657 vs 93655 for CAFE

Date: Nov 28, 2022

Question:

Indication was Afib and Aflutter. "PVI was completed and exit block confirmed for each vein. After PVI, isuprel was started and burst pacing was performed from the CS catheter. Patient was induced for Aflutter, and subsequently an activation map, Ripple map, and coherent map were performed that showed an area of slow zone conduction in the septum of the left atrium; areas were targeted with ablation. Aflutter organized with proximal to distal activation in the CS catheter. Multiple areas in the septum were targeted for complex fractionation. A few areas of complex fractionation noted in the posterior wall as well. These were targeted as well. The catheters were taken to the right atrium, and ablation of the CTI was performed. The flutter was terminated during the ablation in the CTI." One coder thinks this should be coded as 93656, 93655 x 2, and 93623, while the other coder thinks it is 93656, 93657 x 2, 93655, and 93623. What is the correct coding please? Second question, is CAFE always coded as 93657?

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