Question:
Would the statement “recurrence of conduction from prior ablation” documented after PVI was completed be considered Afib after PVI (93657)? What would recurrence of conduction mean?

“Multiple application of the pulse field using Farapulse catheter using basket mode and flower mode with both ostial and antral isolation of all the four pulmonary veins. Post completion of pulmonary vein isolation mapping was performed and revealed evidence for isolation of all the four pulmonary veins.

Left atrial roof ablation: Due to recurrence of conduction from prior ablation, pulse field ablation was delivered in the flower mode of the catheter in the roof aspect with overlapping lesions between the left superior in the right superior pulmonary vein.

Left atrial inferior posterior ablation: Due to recurrence of conduction from prior ablation, pulse field ablation was delivered in the flower mode of the catheter in the inferior posterior aspect with overlapping lesions between the left superior in the right superior pulmonary vein.”

Answer:
Recurrence of conduction means the PV is not isolated from a prior ablation, so you would report code 93656 here for the PVI of the four veins. Report code 93657 once for the roof and floor ablations (part of posterior wall ablation).

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