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Official Description

Programmed stimulation and pacing after intravenous drug infusion (List separately in addition to code for primary procedure)

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 93623 refers to the procedure of programmed stimulation and pacing that occurs after the administration of an intravenous drug infusion. This procedure is typically performed in the context of an electrophysiologic study (EPS), which is a specialized test used to evaluate the electrical activity of the heart and diagnose arrhythmias. During this process, a physician administers an intravenous infusion of a drug, such as isoproterenol or procainamide, which is intended to either induce or suppress an arrhythmia. The infusion of these drugs is crucial as it helps create the conditions necessary for the physician to assess the heart's response to various pacing techniques. Following the drug infusion, the physician engages in programmed stimulation and pacing, which involves delivering timed electrical impulses to the heart. This is done to induce or attempt to induce the arrhythmia, allowing for a comprehensive evaluation of the heart's electrical conduction system. The physician may reposition catheters during this phase to target multiple sites within the heart, ensuring a thorough assessment of the arrhythmia's characteristics. The results of the procedure are meticulously interpreted by the physician, who then compiles a written report detailing the findings and any implications for further treatment or management of the patient's condition.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure associated with CPT® Code 93623 is indicated for the evaluation of various arrhythmias. The following conditions may warrant the performance of programmed stimulation and pacing after intravenous drug infusion:

  • Evaluation of Arrhythmias The procedure is performed to assess the nature and characteristics of arrhythmias, which may include tachycardia or bradycardia.
  • Assessment of Drug Effects It is indicated when there is a need to evaluate the effects of specific antiarrhythmic drugs, such as isoproterenol or procainamide, on the heart's electrical activity.
  • Preoperative Assessment The procedure may be indicated as part of a preoperative assessment for patients undergoing cardiac surgery or procedures that may affect heart rhythm.
  • Risk Stratification It is utilized for risk stratification in patients with known heart disease or those who have experienced syncope or other symptoms suggestive of arrhythmias.

2. Procedure

The procedure for CPT® Code 93623 involves several critical steps that ensure a comprehensive evaluation of the heart's electrical activity following drug infusion. The following steps outline the process:

  • Step 1: Intravenous Drug Infusion The procedure begins with the administration of an intravenous infusion of a drug, such as isoproterenol or procainamide. This drug is selected based on its ability to either induce or suppress arrhythmias, thereby creating the necessary conditions for further evaluation.
  • Step 2: Programmed Stimulation After the drug infusion, the physician performs programmed stimulation. This involves delivering timed electrical impulses to the heart through catheters placed in specific locations. The goal is to induce the arrhythmia or assess the heart's response to pacing at various rates.
  • Step 3: Catheter Manipulation During the pacing and stimulation process, the physician may reposition catheters to target multiple sites within the heart. This allows for a more thorough assessment of the arrhythmia and its characteristics, as different areas of the heart may respond differently to stimulation.
  • Step 4: Interpretation of Results Following the stimulation and pacing, the physician interprets the results obtained from the procedure. This includes analyzing the heart's electrical activity and determining the nature of the arrhythmia. A written report is then generated, summarizing the findings and any recommendations for further management.

3. Post-Procedure

After the completion of the programmed stimulation and pacing procedure, the patient may be monitored for any immediate effects or complications resulting from the drug infusion and electrical stimulation. It is essential to observe the patient for signs of arrhythmia or other cardiac events. The physician will review the findings from the procedure and discuss the implications with the patient, including any necessary follow-up care or additional testing that may be required based on the results. The written report generated during the procedure serves as a critical document for ongoing patient management and treatment planning.

Short Descr PRGRMD STIMJ&PACG IV RX NFS
Medium Descr PROGRAMMED STIMJ & PACG AFTER IV DRUG INFUSION
Long Descr Programmed stimulation and pacing after intravenous drug infusion (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.

93610 Exempt Mod 51 MPFS Status: Carrier Priced APC J1 PUB 100 CPT Assistant Article Illustration for Code Intra-atrial pacing
93612 Exempt Mod 51 MPFS Status: Carrier Priced APC J1 PUB 100 CPT Assistant Article Intraventricular pacing
93619 MPFS Status: Carrier Priced APC J1 PUB 100 CPT Assistant Article Illustration for Code Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, His bundle recording, including insertion and repositioning of multiple electrode catheters, without induction or attempted induction of arrhythmia
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
93653 MPFS Status: Active Code APC J1 Comprehensive electrophysiologic evaluation with insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia with right atrial pacing and recording and catheter ablation of arrhythmogenic focus, including intracardiac electrophysiologic 3-dimensional mapping, right ventricular pacing and recording, left atrial pacing and recording from coronary sinus or left atrium, and His bundle recording, when performed; with treatment of supraventricular tachycardia by ablation of fast or slow atrioventricular pathway, accessory atrioventricular connection, cavo-tricuspid isthmus or other single atrial focus or source of atrial re-entry
93654 MPFS Status: Active Code APC J1 Comprehensive electrophysiologic evaluation with insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia with right atrial pacing and recording and catheter ablation of arrhythmogenic focus, including intracardiac electrophysiologic 3-dimensional mapping, right ventricular pacing and recording, left atrial pacing and recording from coronary sinus or left atrium, and His bundle recording, when performed; with treatment of ventricular tachycardia or focus of ventricular ectopy including left ventricular pacing and recording, when performed
93656 Changed Code for 2025 MPFS Status: Active Code APC J1 Comprehensive electrophysiologic evaluation with transseptal catheterizations, insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia including left or right atrial pacing/recording, and intracardiac catheter ablation of atrial fibrillation by pulmonary vein isolation, including intracardiac electrophysiologic 3-dimensional mapping, intracardiac echocardiography with imaging supervision and interpretation, right ventricular pacing/recording, and His bundle recording, when performed
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.
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
CR Catastrophe/disaster related
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
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.
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
77 Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
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.)
82 Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s).
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GW Service not related to the hospice patient's terminal condition
GZ Item or service expected to be denied as not reasonable and necessary
KX Requirements specified in the medical policy have been met
PD Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days
Q0 Investigational clinical service provided in a clinical research study that is in an approved clinical research study
Q5 Service furnished under a reciprocal billing arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
Q6 Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
RT Right side (used to identify procedures performed on the right side of the body)
TV Special payment rates, holidays/weekends
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
Date
Action
Notes
2025-01-01 Changed Short and Medium Descriptions changed.
2013-01-01 Changed Medium Descriptor changed. Also, revised parenthetical note per AMA corrections document dated 2013-03-22.
2011-01-01 Changed Short description changed.
1990-01-01 Added First appearance in code book in 1990.
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