CPT code 93656 is used for a comprehensive electrophysiologic evaluation and ablation of atrial fibrillation, aiding in precise procedure documentation.
CPT code 93656 is used to describe a comprehensive electrophysiologic evaluation with ablation for the treatment of atrial fibrillation. This procedure involves a detailed assessment of the heart's electrical system to identify abnormal rhythms, specifically atrial fibrillation, and the subsequent use of ablation techniques to destroy the tissue causing these irregular heartbeats. The goal of this procedure is to restore normal heart rhythm and improve the patient's overall cardiac function.
For CPT code 93656, which involves comprehensive electrophysiologic evaluation with ablation for atrial fibrillation, the following modifiers may be applicable:
1. Modifier 26 - Professional Component: This modifier is used when the professional component of the service is being billed separately from the technical component. It indicates that the physician's services, such as interpretation and report, are being billed.
2. Modifier TC - Technical Component: This modifier is used when the technical component of the service is being billed separately. It indicates that the equipment, supplies, and technical support are being billed.
3. Modifier 59 - Distinct Procedural Service: This modifier is used to indicate that a procedure or service was distinct or independent from other services performed on the same day. It is used when procedures are not normally reported together but are appropriate under the circumstances.
4. Modifier 76 - Repeat Procedure by Same Physician: This modifier is used when a procedure or service is repeated by the same physician or other qualified healthcare professional subsequent to the original procedure or service.
5. Modifier 77 - Repeat Procedure by Another Physician: This modifier is used when a procedure or service is repeated by another physician or other qualified healthcare professional subsequent to the original procedure or service.
6. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period: This modifier is used when a related procedure is performed during the postoperative period of the initial procedure.
7. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used when an unrelated procedure or service is performed by the same physician during the postoperative period.
8. Modifier 91 - Repeat Clinical Diagnostic Laboratory Test: Although less common for this type of procedure, this modifier is used when a laboratory test is repeated on the same day to obtain subsequent (multiple) results.
These modifiers help clarify the circumstances under which the procedure was performed and ensure accurate billing and reimbursement. It is important to use them appropriately to avoid claim denials or delays.
CPT code 93656 is reimbursed by Medicare, as it is included in the Medicare Physician Fee Schedule (MPFS). The MPFS is a comprehensive listing of fees used by Medicare to reimburse physicians and other healthcare providers for services rendered. However, the reimbursement for CPT code 93656 can vary based on geographic location and other factors, as determined by the local Medicare Administrative Contractor (MAC). Each MAC is responsible for processing Medicare claims and setting specific payment rates within their jurisdiction, ensuring that the reimbursement aligns with regional cost variations and policy guidelines. Therefore, healthcare providers should consult their respective MAC for precise reimbursement details for CPT code 93656.
Discover the power of MD Clarity's RevFind software to ensure you're receiving the full reimbursement you deserve. With the ability to read your contracts and detect underpayments down to the CPT code level, including specific codes like 93656, RevFind provides unparalleled insight into your revenue cycle. Schedule a demo today to see how RevFind can help you identify discrepancies by individual payer and optimize your financial outcomes.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
