CPT Knowledgebase - Sep 26, 2022

What is the appropriate code to report for a procainamide infusion challenge? This procedure was performed in the electrophysiology and catheterization lab in the event that an intervention is needed, but no catheters were placed in the heart. A 12-lead electrocardiography (ECG) device was placed, with V3 and V4 placed one intercostal space above V1 and V2 for a "high V1 and V2" position. Defibrillation pads were also placed and isoprenaline was in the room in the event of any concerning arrhythmias. Procainamide 10 mg/kg was then infused over 30 minutes. Serial ECGs were performed every 15 minutes during the infusion and for 30 minutes after the infusion. There were no ST segment or other ECG changes with infusion of procainamide that would be suggestive of Brugada syndrome. There were no other issues, concerns, or complications during or after the infusion.

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