# pacemaker complications during global



## jseda (May 12, 2010)

Help!!
I have a rpt on a pt in the global period of dual chamber pacemaker implant for a SSS, who was taken back to the OR because of c/o of CP and lead displacement. 

Generator removed, then LV lead removed and a new LV lead implanted and while LV lead being implanted, the atrial lead was displaced. Atrial lead removed and a new lead implanted. There were several complications that occurred during this procedure and a request for a mod 22 was dictated.

Once tested and readings acceptable, generator and newly placed leads re-implanted back into same pocket.


CPT:    33235 mod 78, 22 
          Since 33208 was original billed out, I do not feel it would be appropriate to rebill with this code.

 Any suggestions or thoughts. Will appreciate any comments.
thanks


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## deeva456 (May 12, 2010)

Hello,

Since the generator was taken out and put back in and was not replaced you cannot bill for the removal of the generator. You can bill for the removal and replacement of the leads.  For pacemakers and ICD units, you bill what you put in. If the doctor mentioned use of "fluoroscopy guidance" you can add 71090-26 but it has to be supported in the report. 

Here are the codes you can bill. 

33235-78 
33217-78

Add modifier 22 to the procedure that had the complication. 

Good luck,
Dolores, CPC-CCC


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## jseda (May 13, 2010)

thank you. You confirmed what my I had summized. Appreciate your help.
J. Seda RN BSN CPC


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