# removal of left ventricle lead



## dms (Mar 19, 2008)

our physician removed a biv icd device and all three lead, in looking for the code for the removal of the LV lead I saw where Boston Scientific had recommened to use 33999 the cardiac surgery unlisted code. 
I was wondering if anyone else has encounted this issue and would I be correct in using procedure code 33999
Thank you for your help


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## Lisa Bledsoe (Mar 20, 2008)

Was it just the removal or were new leads placed?


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## dms (Mar 20, 2008)

*Removal of left ventricle lead*

It's the removal of the whole system  and a new DC ICD was implanted 2 days later.


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## lfuller (Apr 14, 2008)

I also am interested in this, my doctor removed IDC generator and 3 leads and
did not replace. Does 33244 cover all three lead removals?


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## Davistm (Apr 22, 2008)

Report 33241 for removal of the ICD pulse generator and 33244 for the removal of the electrodes.  By description, code 33244 is used to report removal of ICD "electrode(s)" - in this case, all three.  While there is extra work involved in the placement of a biventricular lead [codes 33224 and 33225], there is no extra work in removal.  A biventricular lead is removed in the same manner as other transvenous leads - it is disconnected from the generator, dissected from the scar tissue, twisted counter clockwise and withdrawn.

Terry


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## Davistm (Apr 25, 2008)

After discussions with my fellow coders and some additional research, I want to amend my previous response.

Technically [actually], a bi-ventricular ICD is a three chambered device.  Since the description for code 33244 states "Removal of single or dual chamber pacing cardioverter-defibrillator electrode(s)", it would be appropriate to report code 33999 in addition to 33244.

There may be new codes in 2009 that deal with bi-ventricular device issues: LV lead extraction and device checks/reprogamming.

Always learning,

Terry


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## kmpiper (Apr 30, 2008)

dms said:


> our physician removed a biv icd device and all three lead, in looking for the code for the removal of the LV lead I saw where Boston Scientific had recommened to use 33999 the cardiac surgery unlisted code.
> I was wondering if anyone else has encounted this issue and would I be correct in using procedure code 33999
> Thank you for your help


Hi Terry,
I just read the answer to this question on "The Cardiology Coalition" website, here is the website address:

http://www.cardiologycoalition.com/ 

The answer is the same as what you found but I think you'll find they expand on it too.  It was a great find for cardiology info and after reading their January 2008 Volume 4, Issue 1 you can do a test and receive 2.5 AAPC CEU's.  

Karen Wortmann, CPC


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## dms (May 1, 2008)

Hi Terry & Karen

Thank you both so much for your help, really appreciated it.

Donna


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