Health Information Management

Q/A: Billing code 92960 in the ED

APCs Insider, September 25, 2009

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Q: Is elective cardioversion code 92960 billable in the ED? For example, a patient presents in the ED with heart palpitations and dizziness. The physician, after speaking with the patient, decides to cardiovert the patient to return the heart to a stable rhythm.
 
A: “Elective” is the pivotal word here because the patient presented for an emergent situation which ED clinical staff are treating. 
 
CPT Assistant, November 2000, describes appropriate reporting of an elective cardioversion:
“CPT codes 92960 and 92961 are used to report cardioversion. Code 92960 specifically describes elective (nonemergency) external electrical cardioversion. [emphasis added] Elective cardioversion is most often used to treat atrial fibrillation and atrial flutter if anti-arrhythmic drugs fail to convert the heart back to normal sinus rhythm, or if the patient is hemodynamically unstable. The electric shock given in cardioversion is synchronized (ie, timed to occur during the R wave of the electrocardiogram). The patient will have his/her heart rhythm monitored for several hours after the procedure to ensure the rhythm remains stable.” 
If the ED physician determines that the cardioversion can’t wait until appropriate anti-arrhythmic medications are administered to the patient, then the procedure is not elective.



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