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Coding, Reimbursement and Documentation Resources
US Reimbursement Resources
Coding, Reimbursement and Documentation Resources
US Reimbursement Resources
We understand the importance of tools and education in helping you navigate through the complex EP reimbursement environment. The resources below contain valuable information on EP coding, reimbursement and procedure documentation.
IMAGES
2023 EP Medicare Reimbursement Summary
This summary document provides the Final 2023 Medicare National Average Reimbursement for Hospital Outpatient, Hospital Inpatient, and associated Physician Payments for EP related procedures.
2023 EP Procedure Documentation Best Practices
This guide provides recommendations to facilitate accurate claims processing.
2023 Reimbursement and Coding Guide, Physicians and Facilities
This guide contains ablation related codes and associated Medicare National Average payments. The guide has been developed to assist you in obtaining appropriate physician payment and hospital reimbursement for EP diagnostic and ablation procedures.
2023 Electrophysiology Services Coding Checklist
Offers EPs and lab staff a convenient way to capture the procedures that are completed for each patient. This checklist contains the most common CPT® codes, diagnosis codes and C-codes for EP procedures.
2023 FAQ EP Coding and Reimbursement, Physicians and Facilities
Get the answers to commonly asked reimbursement questions. Use the table of contents to easily find relevant topics, including EP studies, mapping, transseptal access, TEE, ICE C-codes and more.
2023 EP Ablation Coding and Compliance Webinars – Coming Soon
These specialty-specific sessions offer participants a strong educational baseline in EP ablation coding, documentation and reimbursement compliance.
Facility Coding
- Updates to APCs and MS-DRGs
- ICD-10-CM / ICD-10-PCS guidelines
- Inpatient and outpatient case studies
Coming Soon
Physician Coding
- ICD-10-CM documentation considerations
- Case studies illustrating CPT® coding nuances
- CCI bundling issues
- RBRVS updates for 2023
Coming Soon
CPT® codes and descriptors copyright ©2018 American Medical Association. All rights reserved. CPT® is a registered trademark of the American Medical Association.
DISCLAIMER
The information is provided to assist you in understanding the reimbursement process. It is intended to assist providers in accurately obtaining reimbursement for health care services. It is not intended to increase or maximize reimbursement by any payer. We strongly suggest that you consult your payer organization with regard to local reimbursement policies. The information contained in this document is provided for information purposes only and represents no statement, promise or guarantee by Biosense Webster, Inc. concerning levels of reimbursement, payment or charge. Similarly, all CPT® & HCPCS codes are supplied for information purposes only and represent no statement; promise or guarantee by Biosense Webster, Inc. that these codes will be appropriate or that reimbursement will be made. Third party trademarks used herein are trademarks of their respective owners.
Click here for our California Health Care Compliance Information and AdvaMed Code.
In the US, THERMOCOOL® Navigation Catheters are indicated for the treatment of drug refractory recurrent symptomatic paroxysmal atrial fibrillation, when used with CARTO® 3 Systems (excluding NAVISTAR® RMT THERMOCOOL® Catheter).
The THERMOCOOL SMARTOUCH® SF Catheter is indicated for drug refractory recurrent symptomatic persistent atrial fibrillation (AF) (continuous AF > 7 days but < 1 year), refractory or intolerant to at least 1 Class I or III AAD, when used with the CARTO® 3 System.
In the US, THERMOCOOL® Non-Navigational Catheters are indicated for the treatment of Type I Atrial Flutter in patients 18 years of age or older.
THERMOCOOL® Navigation Catheters are indicated for the treatment of recurrent drug/device refractory sustained monomorphic ventricular tachycardia (VT) due to prior myocardial infarction (MI) in adults.
In the US, 4mm Catheters (NAVISTAR® Catheter, CELSIUS® Catheter, EZ STEER® Catheter (NAV and Non-NAV)) have a “General Indication” for creation of endocardial lesions in patients 4 years of age and older. This “General Indication” includes treatment of Ventricular Tachycardia.
Always verify catheter tip location using fluoroscopy or IC signals and consult the CARTO® 3 System User Guide regarding recommendations for fluoroscopy use. Pellegrino, P.L., Brunetti, N.D., Gravina, D., Sacchetta, D., De Sanctis, V., Panigada, S., Di Biase, L., Di Biase, M., and Mantica, M. (2013). Nonfluoroscopic mapping reduces radiation exposure in ablation of atrial fibrillation. Journal of cardiovascular medicine 14, 528-533. Earley, M.J., Showkathali, R., Alzetani, M., Kistler, P.M., Gupta, D., Abrams, D.J., Horrocks, J.A., Harris, S.J., Sporton, S.C., and Schilling, R.J. (2006). Radiofrequency ablation of arrhythmias guided by non-fluoroscopic catheter location: a prospective randomized trial. Eur Heart J 27, 1223-1229
The CARTO VISITAG® Module provides access to data collected during the application of RF energy. The data does not indicate the effectiveness of RF energy application. CARTO VISITAG® Module settings are user defined based on the user’s clinical experience and medical judgment. Biosense Webster, Inc. does not recommend any settings for the CARTO VISITAG® Module.
The CARTO VISITAG® Module provides access to data collected during the application of RF energy. The data does not indicate the effectiveness of RF energy application. Do not use the Tag Index values generated from the VISITAG SURPOINT® EPU to guide RF energy delivery. Equivalent Tag Index values do not represent equivalent RF lesion size. The clinical utility of the Tag Index value has not been established. The Tag Index values should not be used to replace standard handling precautions or other clinically accepted endpoints for RF applications such as reduction of IC signals, impedance drop, and duration. All safety considerations, cautions, and warnings that apply to the general use of the CARTO® 3 System also apply while using this module. Users should follow the instructions for use of the compatible ablation catheters (i.e. THERMOCOOL SMARTTOUCH® Catheter and THERMOCOOL SMARTTOUCH® SF Catheter) to select ablation settings for an ablation procedure.
Use of the PENTARAY® NAV ECO High Density Mapping Catheter may not be appropriate for use in patients with prosthetic valves.
The clinical significance of utilizing the CARTO® CFAE Module to help identify areas with complex fractionated atrial electrograms for catheter ablation of atrial arrhythmias, such as atrial fibrillation, has not been established by clinical investigations.
The clinical significance of utilizing the PASO® Module to help pace mapping for catheter ablation of ventricular arrhythmias has not been demonstrated by clinical investigations.
Bertaglia E, Bella PD, Tondo C, Proclemer A, Bottoni N, De Ponti R, et al. Image integration increases efficacy of paroxysmal atrial fibrillation catheter ablation: results from the CARTOMERGE® Module Italian Registry. Europace 2009;11:1004-1010.
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This site was last updated on February 1, 2023. 164930-210323