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The CPT® Code 93621 refers to a comprehensive electrophysiologic evaluation that includes the insertion and repositioning of multiple electrode catheters, with the specific focus on left atrial pacing and recording from either the coronary sinus or the left atrium. This procedure is performed in conjunction with the primary electrophysiologic study, which is detailed under CPT® Code 93620. During this evaluation, the physician aims to induce or attempt to induce arrhythmia, which is a condition characterized by irregular heartbeats. The procedure involves accessing the heart through a blood vessel, typically in the groin, where catheters equipped with recording and stimulating electrodes are inserted. These catheters are then navigated into the heart's right atrium and right ventricle to measure and record electrical activity, as well as to pace the heart. The bundle of His, a critical component of the heart's electrical conduction system, is also monitored during this process. Following the comprehensive study, the physician performs left atrial pacing and recording, which involves placing an electrode catheter in the coronary sinus or left atrium to obtain optimal electrocardiogram (ECG) recordings. This additional step is crucial for a thorough evaluation of the heart's electrical activity and for the potential induction of arrhythmias from the left atrial site.
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The procedure associated with CPT® Code 93621 is indicated for the evaluation of various arrhythmias and related cardiac conditions. The following are the explicitly provided indications for performing this comprehensive electrophysiologic evaluation:
The procedure for CPT® Code 93621 involves several critical steps that ensure a comprehensive evaluation of the heart's electrical activity. The following procedural steps are performed:
After the completion of the procedure associated with CPT® Code 93621, several post-procedure care steps are typically followed. The physician will monitor the patient for any immediate complications, such as bleeding or arrhythmias. The puncture or incision sites will be assessed for proper healing, and pressure will be maintained to minimize the risk of hematoma formation. Patients may be advised to rest and avoid strenuous activities for a specified period following the procedure. Additionally, the physician will review the results of the electrophysiologic study with the patient, discussing any findings and potential next steps in management or treatment based on the induced arrhythmias or electrical conduction abnormalities observed during the evaluation.
| Short Descr | COMP EP EVL L PAC&REC C SINS | Medium Descr | COMPRE EP EVAL W/L ATRIAL PACG&REC C SINS/L ATR | Long Descr | Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left atrial pacing and recording from coronary sinus or left atrium (List separately in addition to code for primary procedure) | Status Code | Carriers Price the Code | Global Days | ZZZ - Code Related to Another Service | 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 | Items and Services Packaged into APC Rates | 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 |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 93620 | MPFS Status: Carrier Priced APC J1 PUB 100 CPT Assistant Article Illustration for Code Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with right atrial pacing and recording, right ventricular pacing and recording, His bundle recording |
| 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. | GC | This service has been performed in part by a resident under the direction of a teaching physician | 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. | 25 | Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service: it may be necessary to indicate that on the day a procedure or service identified by a cpt code was performed, the patient's condition required a significant, separately identifiable e/m service above and beyond the other service provided or beyond the usual preoperative and postoperative care associated with the procedure that was performed. a significant, separately identifiable e/m service is defined or substantiated by documentation that satisfies the relevant criteria for the respective e/m service to be reported (see evaluation and management services guidelines for instructions on determining level of e/m service). the e/m service may be prompted by the symptom or condition for which the procedure and/or service was provided. as such, different diagnoses are not required for reporting of the e/m services on the same date. this circumstance may be reported by adding modifier 25 to the appropriate level of e/m service. note: this modifier is not used to report an e/m service that resulted in a decision to perform surgery. see modifier 57 for significant, separately identifiable non-e/m services, see modifier 59. | 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.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | CR | Catastrophe/disaster related | ET | Emergency services | GW | Service not related to the hospice patient's terminal condition | GZ | Item or service expected to be denied as not reasonable and necessary | 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 | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2025-01-01 | Changed | Short and Medium Descriptions changed. |
| 2017-01-01 | Changed | Moderate (Conscious) Sedation flag removed. See new Moderate Sedation category. |
| 2013-01-01 | Changed | Guideline information changed. |
| 2003-01-01 | Changed | Code description changed. |
| 2002-01-01 | Changed | Code description changed. |
| 1990-01-01 | Added | First appearance in code book in 1990. |
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