by David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC
Patient has AF and atrial flutter. After completion of successful PVI, the physician performs a typical atrial flutter ablation. Three-dimensional mapping and conventional catheter mapping were performed using this ablation catheter and the left atrial coronary sinus decapolar catheter. Multiple radiofrequency lesions were administered, resulting in gradual slowing of the atrial flutter with eventual termination. The ablation catheter was then placed in the lower lateral right atrial wall, and pacing was performed from the coronary sinus catheter from coronary sinus. Conduction times across the caval tricuspid isthmus were noted to be  ms in both directions confirming a bidirectional block across the isthmus.
We were going to bill 93656 for the PVI and 93655 for the atrial flutter ablation, but the physician is thinking we should bill an additional 93655 for the CTI. Would you please review and see if we should add the additional code?
We only see one mechanism, which is typical a-flutter ablation here, so you would only report 93655 once.
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