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93653 vs 93656 for left sided Atrial Aflutter

Date: Sep 5, 2023

Question:

Patient is being treated in the office for atrial fibrillation. Pt has had prior A-Fib ablation, cavotricuspid isthmus and ablation of lt atrial posterior wall. Pt has successful cardioversion. comes back to discuss re-do A-fib ablation.

Pt present to EP Lab in Atrial Flutter. 3-D map of rt atrium show left sided flutter. Septum crossed. Map of the lt atrium show atypical left atrial flutter. Ablation of Superior lt PV to the mitral annulus. Tachycardia slowed ultimately terminated to SR.

RT SPV and LPV showed no signal. Left superior PV and left inferior PV revealed reconnection. A few signal on posterior wall.Ablation was performed lt SPV at the roof. Ablation lt inferior PV at the posterior wall was also performed.

Physician thinks 93656,93657,93657 because of work done. I think 93653,93655 (redo).What are you thoughts?

Question ID : 18275
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