# Stent , cardiac cath with temporary pacemaker



## Pillow1 (Dec 10, 2009)

STENT , CARDIAC CATH WITH TEMPORARY PACEMAKER

OK TO PUT BILL 33210-59 WITH STENT AND CARDIAC CATH?
ANY INPUT WOULD BE APPRECIATED

75898-26  -ANGIOGRAPHY FOLLO  
33210-59  -TEMPORARY PACEMAK  
92980-LC  -STENT PLACEMENT S  
93556-2659-PULMONARY/CORONAR  
93555-2659-IMAGING/INTERP/RP  
93545     -INJ OF RADIOPAQUE  
93543     -INJ. DURING CATHE  
93510-26  -LEFT HEART CATHET 

PROCEDURE:                                                                    
1.     Cardiac catheterization.                                               
2.     PTCA.                                                                  
3.     Emergency pacemaker placement.                                         

INDICATION:                                                                   
Acute inferior wall MI, severe bradycardia/hypotension/cardiogenic            
shock.   
           IMPRESSION:                                                                   
1.     Overall normal left ventricular function with an EF of 55% to          
60%.                                                                          
2.     No MR noted.                                                           
3.     Significant coronary artery disease noted with 99%                     
obstruction in the mid circumflex with thrombus noted in that                 
area, 30% to 40% irregularities in the LAD and RCA as well.  The              
RCA was a codominant system, and a 75% stenosis noted in the 3rd              
diagonal.  This is a small to medium caliber type vessel.                     
4.     Successful placement of emergency pacemaker in the RV cavity           
with normal function.                                                         
5.     Successful PTCA/stenting of the mid circumflex with a 3.0 x            
28-mm Liberte stent taken up to 16 atmospheres and intracoronary              
Adenocard given as well.                                                      
6.     Diver catheter used initially.                                         
7.     Followup angiography showed TIMI-3 flow with 0% residual.              

RECOMMENDATION:                                                               
Follow post stent protocol.


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## vsmith (Dec 10, 2009)

*vsmith*

you are correct about the codes. Medicare just paid a case just like this. vicki


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## Pillow1 (Dec 10, 2009)

Thank you so much vicki  for your positive response, also we added  71090-26  -pacemaker inserti for the s & i to support the 33210


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## 10marty (Dec 10, 2009)

Why did you code 75898, new at this, a little confused at times.

Marty


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## Jim Pawloski (Dec 11, 2009)

10marty said:


> Why did you code 75898, new at this, a little confused at times.
> 
> Marty



This code should not have been used.  This code is for follow-up of embolization or lysis infusion injections.  Follow-up angio is part of the angioplasty code.

Thanks,
Jim Pawloski CIRCC


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