Cardiac Electrophysiology CDI

Brugada Syndrome Specific documentation required:

Puncture Complications Pneumothorax after device implant. Document:

External Cause Codes If an arrhythmia was caused by electric shock (AC/DC). Document:

Cardiac Resynchronization Therapy (CRT) When implanting a CRT-D, justifying medical necessity requires documenting:

Renal Insufficiency Before starting dofetilide, you check kidneys. Document:

Syncope Etiology A patient is admitted for Syncope. You find a pause of 6 seconds. The Principal Diagnosis should be:

Mechanical Complication of Device A lead has dislodged. Document:

Hematoma Post-Implant A small hematoma forms at the pocket site.

Atrial Flutter Distinguish from Afib:

Inappropriate Shocks Due to SVT or noise. Document:

Hypertension Even in EP, HTN affects risk. Document:

Anticoagulation for Procedures You bridge a patient with Heparin. Document:

Twiddler's Syndrome Patient manipulates device causing lead failure. Document:

Tobacco Dependence Vaping or smoking. Document:

Cardiac Perforation (Tamponade) During ablation, pressures drop. Document:

Drug-Induced Arrhythmia Patient has Torsades from Sotalol. Document:

Failed Sedation The patient becomes agitated during the procedure, requiring intubation. Document:

Heart Failure in EP Patients You are admitting a patient for an ICD generator change. They have ischemic cardiomyopathy. You must document:

Phrenic Nerve Injury Diaphragm paralysis after Cryo. Document:

Pacemaker Syndrome Patient feels worse after VVI pacing. Document:

Tricuspid Regurgitation During lead placement, you note severe TR. Document:

Supraventricular Tachycardia (SVT) "SVT" is a bucket term. If known, specify:

Sick Sinus Syndrome vs. Bradycardia A patient presents with syncope and a heart rate of 35. A pacemaker is planned. Documenting "Sick Sinus Syndrome" is superior to "Bradycardia" because:

Bundle Branch Blocks Document:

Left Atrial Appendage (LAA) Thrombus Found on TEE prior to cardioversion. Document:

Obstructive Sleep Apnea (OSA) A high percentage of Afib patients have OSA. Document:

Device Infection: Pocket vs. Systemic A patient with a pacemaker presents with redness at the site and fever. You must distinguish:

End of Life / Battery Depletion Admitted for elective replacement (ERI). Document:

Demand Ischemia (Type 2 MI) A patient goes into rapid AFib (RVR 160) and Troponin bumps to 0.12. Coronaries are clean. Document:

Premature Depolarizations If a patient is symptomatic from PVCs/PACs, document:

Cardiac Arrest during Procedure If a patient requires defibrillation during an EP study (induced), do you code Cardiac Arrest?

Electrolyte Imbalance You cancel a case because K+ is 2.9. Document:

Long QT Syndrome Document:

Ventricular Tachycardia Types "VT" is vague. Specify:

Cardiomyopathy Specificity "Cardiomyopathy" (I42.9) is unspecified. Better to document:

Vasovagal Syncope Specific terminology:

Cardiac Sarcoidosis If suspected as arrhythmia cause. Document:

Lead Fracture A patient presents with shocks due to lead noise. X-ray confirms break. Document:

Post-Ablation Pericarditis After an AFib ablation, the patient has chest pain and ST elevation. To code this as a complication, document:

Chronic Total Occlusion (CTO) If placing a lead is difficult due to venous occlusion, document:

Hyperlipidemia Routine but relevant. Document:

Obesity BMI >40 impacts fluoroscopy times and risk. Document:

Congenital Anomalies in Adults You treat an adult with WPW. Document:

AV Block Degrees Specify:

Atrial Fibrillation Specificity "Afib" is the most common diagnosis, but the code I48.91 (Unspecified) is a red flag.