# temporary pacemaker



## dpumford (Feb 20, 2009)

Yes, as long as it is medically necessary, ie: complete heart block.


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## kbarron (Feb 20, 2009)

*Cardiology help??*

We have a pt w/complete heart block. The procedure note is very minimal:
"Lt subclavian area was sterilized and using the modified Seldinger technique, a 6 French cordis was introduced with good blood flow, then the balloon tip placer was floated into the right ventricle with good capture with a rate of 70  and MA II sensitivity of 1. CXP confirms good placement of the ER-tube and the pacemaker." I am not too swift on cardiology, however I am having a hard time coding this. I did find out that the internal med Doc subsequently placed a transvenous pacemaker left subclavian. This note was from the Cardiologist who happened to be at the hospital this day. I am looking at 33212. The problem I see is that none of the notes mention a generator. Pt was shipped out the next day for permanent placement. Thanks in advance.


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## dpumford (Feb 20, 2009)

If I am reading this correctly you want to bill for a temporary PPM placement?

The report looks like it is for the temporary PPM which would be 33210, single,  If floursocopy was done you could also bill 70190, but Ido not see a mention of flouroscopy.

Hope this helps!


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## kbarron (Feb 20, 2009)

Thanks very much. This is all the report states. I don't see enough information. That is why I put it on the forum.


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## dpumford (Feb 24, 2009)

A temporary pacemaker is not always needed when doing a PPM Insert or replacement.  Patient has to be pacemaker dependent and will require a 59 modifer.  

You can verify with Heart Rhythm Society  Procedure and Service Coding Guide book.


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