# reposition impella device



## bdempsey (Oct 23, 2012)

Would you use 33999 for repositioning of Impella under fluoro and echocardiographic guidance?


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## CPCCODERII (Oct 24, 2012)

We use 33999 and place a note in field 19 stating "Impella 2.5 repositioning, records available upon request"  

HTH


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## wavesograin (Oct 24, 2012)

Our cardio clinic has billed this the same way, with the description in box 19. The only carrier we are having problems with is Medicare, in getting 33999 paid.


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## CPCCODERII (Oct 24, 2012)

We are unfortunately having problems with Medicare and Medicare other plans.  But our issue is our nurses not obtaining prior authorizations, and since the Impella is an unlisted code and viewed as "experimental" still (even though FDA approved), they require a prior authorization.  

We are hoping CPT will have a code for the Impella in 2013


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## jewlz0879 (Oct 24, 2012)

There are a few new VAD codes but I'm not sure they apply to Impella; mainly because I don't see code for the open femoral cutdown approach (Impella 5.0). If you're doc is doing these percutaneously,and feels the CPT code matches the work done, the codes below might provide relief from unlisted denials. 

33990 Insertion of ventricular assist device, percutaneous including radiological supervision and interpretation; arterial access only. 

33991 Insertion of VAD, percutaneous including S&I; both arterial and venous access, with transseptal puncture. 

33992 Removal of percutaneous VAD at a _separate_ and distinct session from insertion. 

33993 Repositoning...."....at separate and distinct session from insertion. 

I looked at the new Category III codes but didn't see anything pertaining to Impella. 

HTH


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