Ask Dr. Z

2013 Book Errata 2/5/13, pg 412, Coding Instructions, 8., states “According to the Heart Rhythm Society 2013 Coding Guide, ablation of Aflutter after PVI is reported with add-on code 93657.” 3/29/13 Question ID 4737 you advised to use 93656 and 93657 for a pt with both Afib & Aflutter. (OK so far.) 7/2/13, Question ID 4950 you advised “As the physician never documented ‘persistent Afib’ after the PVI, I would not report any additional codes for the additional ablation locations in LT atrium. I would report the Aflutter on the RT side with 93655 currently (as it is not persistent Afib).” (Confusion begins.) 7/9/13 AMA Errata, pg 20, beneath 93657 and 93662, states “Revise the intracardiac electrophysiologic procedures/studies guidelines to: 1) allow reporting code 93622 & 93623 with 93653-93657; 2) remove the terms “treatment of atrial fibrillation”; Where is the term “treatment of atrial fibrillation” being removed from, code 936537? Please clarify when it is appropriate to use 93657 vs 93655 with 93656 for Aflutter ablation after PVI.