The ICD-9-CM Coordination and Maintenance Committee oversees diagnosis codes and inpatient hospital procedure codes. During the committee’s September 2005 meeting ,electrophysiology studies (EPS) were discussed. There is considerable coding confusion with regard to the various clinical cardiac EPS and their relationship with cardiac devices. Coding refinement is necessary to accurately describe these procedures. In the current coding structure both the Catheter Dependent EPS and the Noninvasive EPS are coded the same with code 37.26 (Cardiac electrophysiologic stimulation and recording studies, Electrophysiologic studies [EPS], Non-invasive programmed electrical stimulation (NIPS), Programmed electrical stimulation). This coding confusion may have contributed to the removal of EPS out of DRGs 535 (Cardiac Defibrillator Implant with Cardiac Catheterization with Acute Myocardial Infarction, Heart Failure, or Shock) and 536 (Cardiac Defibrillator Implant with Cardiac Catheterization without Acute Myocardial Infarction, Heart Failure, or Shock).
The Heart Rhythm Society, working in conjunction with others, encouraged CMS to recommend a change to this coding structure. CMS recommended to the committee: Revise the title of code 37.26 to Catheter based invasive electrophysiologic testing and create a new code 37.20 Noninvasive programmed electrical stimulation (NIPS) and include exclusionary notes. (Excludes: that as part of introperative testing – omit code / catheter based invasive electrophysiologic testing – 37.26 / device interrogation only without arrhythmia induction (bedside check) – 89.45 – 89.49). HRS will keep you informed about the progress of these changes.
If you have questions or comments please contact Allison Waxler at 202-464-3433 or awaxler@hrsonline.org.
