# Pacemaker



## armymomryan (Jun 4, 2010)

Getting real good coding the caths and stress test, starting to see the pacers coming across my desk, anyone lend a hand?? Thanks

Procedure performed: Placement of left internal IV with transvenous pacemaker under fluoroscopy.

DX: Sick sinus syndrome, (427.81)

Descrip. of procedure: Left cervical area was prepped and draped sterilely.  IV Lidocaine was used to numb up to the sternocleidomastoid triangle.

Under fluoroscopy and using the Seldinger technique, the left jugular vein was accessed. Placement was confirmed w/ guidewire into right atrium.  A 5-French introducer was then placed, aspirated and flushed. Under fluoroscopy, a 5-French temp. pacer wire was advanced to the RV apex. After confirming sensitivity of less than 1mA, the previously placed right internal jugular temp pacer line was discontinued. The left IJ introducer was sutured into place.

33206-26
33210-26,59
71090
77001
31720

These are guesses, am I even close (???)


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## sbicknell (Jun 4, 2010)

Is this the entire documentation of the procedure? Cause it seems confusing. I could be wrong but the dictation seems to be based on "you know what I did, I do these all the time" rather than clearly documenting the specifics of the procedure. Maybe someone else can make sense of this and give you the correct coding

_Under fluoroscopy and using the Seldinger technique, the left jugular vein was accessed. Placement was confirmed w/ guidewire into right atrium. A 5-French introducer was then placed, aspirated and flushed. Under fluoroscopy, a 5-French temp. pacer wire was advanced to the RV apex. After confirming sensitivity of less than 1mA, the previously placed right internal jugular temp pacer line was discontinued. The left IJ introducer was sutured into place._

Under fluoroscopy and using the Seldinger technique, the left jugular vein was accessed. ---ok

Placement (of what???) was confirmed w/ guidewire into right atrium

A 5-French introducer was then placed (where???), aspirated and flushed. 

Under fluoroscopy, a 5-French temp. pacer wire was advanced to the RV apex. --ok

After confirming sensitivity of less than 1mA, the previously placed right internal jugular temp pacer line was discontinued. (huh? and does discontinued mean removed?)

The left IJ introducer was sutured into place.  (huh? what introducer and where?)


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## armymomryan (Jun 4, 2010)

yeah, that is the complete documentation that I received


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## sbicknell (Jun 4, 2010)

Well, I consider myself pretty good with Cardio but I just can't make heads-or-tails of this. I hope you will get a response as I am curiuos how this could be coded. Sorry I couldn't be more help


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