AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2020 Issue 1; Ask the Editor

Ablation Convergent Procedure (Catheter-Based and Thoracoscopic Ablations)

The patient is a 65-year-old man, who presents with symptomatic persistent atrial fibrillation (AF) despite medical therapy, and was referred for redo ablation procedure. A hybrid ablation convergent procedure was done, in which the cardiologist performed a catheter-based ablation in the electrophysiology (EP) laboratory, and the cardiothoracic surgeon performed an ablation via a thoracoscopic (subxiphoid) approach. During the procedure, the skin over the xiphoid was incised and the fascia was divided. The xiphoid was dissected until the pericardium was reached and a window was created. The cannula was inserted, as was the zero degree scope. The ablation was started using end contact probe. Overall, 26 ablation lines were created going sequentially from the right side to the left side as high up towards the roof at the pericardial reflection as feasible. The patient was transferred to the EP laboratory and underwent targeted ablation under fluoroscopic guidance with electroanatomic mapping (EAM). Protamine was then used to reverse anticoagulation and the sheaths were pulled. How should a hybrid ablation convergent procedure done via two surgical approaches be coded? ...

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