Not appropriate to report coding for cardio-pulmonary resuscitation (92950) when defibrillation is performed

Q.

We had a patient who presented to the cath lab with chest pain. During injection of the RCA, the patient’s rhythm went into ventricular tachycardia then to ventricular fibrillation. The doctor shocked the patient twice to convert the patient back to sinus rhythm. Can we submit CPT^® code 92950? If not, is there another CPT code we can bill?

A.

If the doctor performed defibrillation, it would not be appropriate to report cardio-pulmonary resuscitation (92950). And since this wasn’t elective cardioversion, you can’t report 92960 either. 

According to the American Medical Association (AMA): 

“Defibrillation is the delivery of an electrical impulse to the heart. This impulse is intended to interrupt abnormal rhythms (e.g., ventricular fibrillation) and allow the normal sinus impulse and electrical conduction to resume. The electrical impulse must be strong enough to cause depolarization (neutralization of the positive and negative electrical charges) of a large percentage of the myocardium. The time of the defibrillation is not synchronized to the cardiac cycle.

There is no CPT code to use to report defibrillation as a procedure performed in isolation. Defibrillation may be performed as part of critical care services or at the end of open-heart surgery or during cardiac catheterization or during an electrophysiological procedure. In all of these situations, defibrillation is not a separately reportable service; code 92960 should not be used to report defibrillation.”