# biventricular pacers



## lfuller (Jan 21, 2008)

Can anyone advise on billing L heart cath before insertion of bi-ventricular
pacer? also on subclavian venogram preceding insert? We've just started doing these.  Also, does anyone know if CMS or WPS Medicare has a recent
policy on these?   Thanks!!!


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## Davistm (Jan 25, 2008)

Did the physician place the left ventriclar lead at the same time that the PM or ICD was implanted or did the physician upgrade an existing PM/ICD system?

You can reply privately or call me at 405-608-1207.


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## Davistm (Jan 28, 2008)

Based on the information you provided, coding should be 33208, 33225 and 71090-26.  All injections and imaging during the procedure are condidered to be for fluoroscopic guidance and are bundled into the codes above. 

There are NCDs for PM and ICD placement.  Check CMS Pub 100-3, Chapter 1, Section 20.4 [ICD] and 20.8 [PM]. This policy pre-empts LCDs.


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