2022 Medicare Physician Fee Schedule final rule reports some changes in Electrophysiology codes. These bundling updates by CMS eliminate separate payment when performed with supraventricular tachycardia (SVT) ablation – 93653 and atrial fibrillation (A-Fib) ablation – 93656. These services include:
As a result of these coding updates, the following add-on coding combinations are now bundled into the primary EP & ablation procedure that could have been billed separately before. In this article we shall discuss these updates and what they entail for the coding of EP procedures moving forward.
Separate Ultrasound guidance is now also bundled into EP procedures:
The coding combinations that you should look for while coding EP procedures:
Try to keep in mind the following table for cross-checking EP coding combinations for whenever they are billed at your Practice. This table can help simplify coding scenarios where you can unbundle and bill the procedures separately.
Inherent:
Means the service is already part of the Primary code and there is no need to bill it separately.
Bundled:
Means the service is packaged into the Primary code and cannot be billed separately.
Not Bundled:
Means you may bill this service separately by appending appropriate Modifiers. i.e., 51 or 59.
Following these Bunding updates, make sure you don’t bill services which are already inherent to the EP procedure and secondly avoid the coding combinations which can lead to bundling ambiguities. It is vital to go through the medical documentation following these updates. This will give an idea to which services were performed that can in turn make it easier to un-bundle these EP procedures, using appropriate modifiers.
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