Cardiology Question for the Week of December 8, 2025

Question:

Code 92960 cardioversion before the EP ablation procedure, is it allowed for reimbursement, and is a separate consent for the cardioversion due to it being an elective procedure recommended?

Answer:

Yes—cardioversion (92960) may be separately reportable when it is performed for a distinct clinical purpose and not inherent to the ablation procedure itself. • If the cardioversion is performed solely to facilitate mapping or induce rhythm as part of the EP ablation workflow, it is considered bundled into the ablation service and not separately billable. • If the patient presents in an arrhythmia requiring cardioversion as a therapeutic intervention prior to proceeding with the ablation, medical necessity can support separate reporting of 92960. Payers may still deny coverage as inclusive if they determine that it is performed to facilitate the ablation rather than for an independent medical necessity. Therefore, documentation must clearly support the clinical need for cardioversion, that it is not part of the planned ablation workflow, and that it requires separate physician work. Consent: Because elective cardioversion carries independent procedural risks (e.g., sedation, thromboembolic risk), obtaining a separate informed consent is considered best practice when cardioversion is performed as a distinct, billable service. This protects both compliance and integrity, as well as the provider, by demonstrating that the cardioversion was a distinct, medically necessary event.