Summary & Overview
CPT 93622: Left Ventricular Pacing and Recording (Add-On)
CPT code 93622 is an add-on intracardiac electrophysiology procedure used to place an additional catheter for left ventricular pacing and recording after initial induction of an arrhythmia and right-sided/bundle of His recordings. Nationally, this code is significant for documenting advanced invasive electrophysiology mapping and pacing maneuvers that support arrhythmia diagnosis and procedural planning. It is typically reported in conjunction with primary electrophysiology procedures and billed from hospital cardiac catheterization or electrophysiology labs.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical intent of the code, typical service setting, and which payers commonly cover related electrophysiology services. The publication also summarizes benchmark considerations, common modifier usage provided in the input, and clinical context for when left ventricular pacing and recording is performed as part of comprehensive intracardiac evaluation.
This executive summary equips administrators, coding professionals, and clinicians with a clear understanding of what CPT code 93622 represents, why it is used in the care pathway for arrhythmia evaluation, and what to expect when documenting and reporting this add-on intracardiac procedure.
Billing Code Overview
CPT code 93622 describes an add-on intracardiac pacing and recording procedure performed after initial induction of an arrhythmia. In this procedure the provider advances an additional catheter through a venous sheath and positions it under fluoroscopic guidance for left ventricular pacing and recording, following prior pacing and recording of the right heart and bundle of His.
Service type: Diagnostic/operative intracardiac electrophysiology procedure (add-on)
Typical site of service: Hospital cardiac catheterization laboratory or electrophysiology lab; may also be performed in an ambulatory surgical center with electrophysiology capabilities
Clinical & Coding Specifications
Clinical Context
A 68-year-old male with ischemic cardiomyopathy and recurrent ventricular tachycardia is brought to the electrophysiology (EP) lab for invasive arrhythmia evaluation and catheter ablation planning. After conscious sedation and vascular access via the right femoral vein, the EP physician induces arrhythmia with programmed electrical stimulation and records signals from the right atrium, right ventricle, and His bundle. To assess left ventricular activation and to pace and record directly from the left ventricle, the physician advances an additional pacing/recording catheter through an existing venous sheath and navigates it under fluoroscopic guidance to the left ventricular endocardium (via a transseptal puncture or coronary sinus approach as clinically appropriate). Continuous hemodynamic and fluoroscopic monitoring is maintained. Data from left ventricular pacing/recording is used to localize arrhythmogenic substrate, confirm conduction properties, and guide subsequent mapping or ablation steps. Typical sites of service include the hospital outpatient or inpatient electrophysiology laboratory and the ambulatory surgical center when equipped for invasive EP procedures. The service type is an invasive electrophysiology add-on catheter placement for left ventricular pacing/recording performed in conjunction with baseline right-sided EP study maneuvers.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier / default | Use when no special modifier applies; many payers do not recognize two-digit but it appears in the list as default billing state. |