# ICD generator change with lead eval



## Robbin109 (Jun 14, 2013)

In the CPT book it says Fluroscopy can't be used with codes 33206-33249 but to report fluorscopic guidance for diagnostic lead evulation w/o lead insertion, replacement or revision prodecures use 76000.

I have a procedure where the MD did a ICD generator change (33263) and then under fluorscopy check the leads for position. This sounds like it falls under the guidelines to bill 76000.  I'm I correct?


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## TWinsor (Jun 17, 2013)

Robbin109 said:


> In the CPT book it says Fluroscopy can't be used with codes 33206-33249 but to report fluorscopic guidance for diagnostic lead evulation w/o lead insertion, replacement or revision prodecures use 76000.
> 
> I have a procedure where the MD did a ICD generator change (33263) and then under fluorscopy check the leads for position. This sounds like it falls under the guidelines to bill 76000.  I'm I correct?



According to the guidelines the 76000 is only reportable for diagnostic lead evaluation without insertion, replacment or revision procedures/  Since your physician is checking position of the lead after placing I would say this is not a diagnostic evaluation and should not be billed. 

Just my opinion....


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## Twixle2002 (Jun 17, 2013)

I would bill it with the  76000 because the physician only did a generator change.  As long as he did nothing to the leads you should be fine to bill flouroscopy.


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## TWinsor (Jun 18, 2013)

Checking lead position after placement is not the same as evaluating a lead.


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## Robbin109 (Jun 19, 2013)

What would consider "evaluation of a lead"?

The CPT books says " Radiological supervision and interpretation related to the pacemaker or pacing cardioverter-defibrillator procedure is included in 33206-33249. To report fluoroscopic guidance for diagnostic lead evaluation without lead insertion, replacement, or relacement or revision procedures, use 76000"

....so it's not ANY insertion/replace/revision procudures, but LEAD insert/replace/revision procedures.

He is basically checking the positions of the leads after changing the battery which he needs fluroscopy to do. Code 33263 isn't included in the range 33206-33249 mentioned above.

Thoughts?


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