# Biventricular capping



## Samson9697 (Sep 5, 2012)

I am stuck on how to code the following scenario: 

PROCEDURE PERFORMED:
Lead Revision

The doctor disconnected the biventricular ICD from the leads.  There was an old right ventricular pace/sense lead present that was previously capped.  He uncapped this lead, tested it and found it to be acceptable to use on the RV pace/sense position.  The RV pace/sense portion of the defribrillation lead was capped.  The leads were reconnected and the device tested.

Can we only code for the testing, 93462, since there was no insertion or replacement?  Or is there another code we can use?  We looked at 33215, but was not sure if this was acceptable.

Please Help!!!!


----------



## twizzle (Sep 5, 2012)

Samson9697 said:


> I am stuck on how to code the following scenario:
> 
> PROCEDURE PERFORMED:
> Lead Revision


A little more information would help.


----------



## hewitt (Sep 5, 2012)

I agree. We need more detail. From what you have given us, a revision/repositioning of the lead(s) was not done. Was anything replaced?


----------



## Samson9697 (Sep 5, 2012)

This is  the only documentation that we have.  Nothing was replaced or inserted.  After much discussion, we are pretty sure that we can only bill for the testing and nothing else.  Wanting to see is any one else agrees.  Do you think we can code for the testing?


----------



## hewitt (Sep 5, 2012)

I would. If you do not mind, which CPT(s) are you going to use?


----------



## twizzle (Sep 5, 2012)

If that is the only information, I would say it is an unbillable service. An auditor would agree. There isn't even a diagnosis to show medical necessity.


----------



## Samson9697 (Sep 5, 2012)

The code we were thinking of is 93642, (Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parameters).


----------



## twizzle (Sep 5, 2012)

What Dx code would you use?
The provider is saying lead revision. 93642 is not for lead revision, it is for non-invasive program stimulation for an ICD, You cannot bill this or any other procedure based on the statement 'lead revision'.


----------



## jewlz0879 (Sep 6, 2012)

What about codes from 93279-93292? Per Dr. Z, you can't bill for capping.


----------

