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The CPT® Code 93600 refers to the procedure known as Bundle of His recording. This procedure involves the physician obtaining recordings from the bundle of His, which is a critical component of the heart's electrical conduction system. The bundle of His, also known as the atrioventricular bundle, consists of specialized conducting fibers that play a vital role in transmitting electrical impulses from the atria to the ventricles, facilitating coordinated heart contractions. During the procedure, one or more access veins, typically the femoral or jugular veins, are selected for catheter insertion. The skin over these access sites is prepared, and the veins are punctured using a needle, followed by the placement of sheaths to facilitate catheter insertion. Continuous fluoroscopic guidance is employed to insert and advance guidewires from the access veins into the heart. Once the guidewires are in place, catheters are advanced over them and positioned within the heart chambers. After the guidewires are removed, recordings of the electrical activity in the bundle of His are obtained using an electrode-mounted catheter. This test is crucial for assessing the electrical activity within the bundle of His, as any interruption or blockage in this area can lead to irregular heartbeats. The physician subsequently reviews the recordings and generates a written report detailing the findings of the procedure.
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The Bundle of His recording (CPT® Code 93600) is indicated for the evaluation of various cardiac conditions where the assessment of electrical conduction is necessary. The following conditions may warrant this procedure:
The Bundle of His recording procedure involves several critical steps to ensure accurate recordings of the heart's electrical activity. The following procedural steps are performed:
After the Bundle of His recording procedure, the patient may be monitored for any immediate complications related to the catheterization process. It is essential to observe the access site for signs of bleeding or infection. The physician will review the recordings and provide a detailed report, which may guide further management or treatment options based on the findings. Patients may be advised on any necessary follow-up appointments or additional testing that may be required to address any identified issues related to their cardiac health.
| Short Descr | BUNDLE OF HIS RECORDING | Medium Descr | BUNDLE OF HIS RECORDING | Long Descr | Bundle of His recording | Status Code | Carriers Price the Code | Global Days | 000 - Endoscopic or Minor Procedure | PC/TC Indicator (26, TC) | 1 - Diagnostic Tests for Radiology Services | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P2F - Major procedure, cardiovascular-Other | MUE | 1 | CCS Clinical Classification | 62 - Other diagnostic cardiovascular procedures |
| 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | AO | Alternate payment method declined by provider of service | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| Pre-1990 | Added | Code added. |
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