# Upgrade to dual chamber ICD



## denisek1028 (Mar 19, 2015)

Patient upgraded from dual chamber pacemaker to dual chamber ICD.  Physician removed right ventricular pacing lead, dual chamber pacemaker, implanted dual coil implantable cardioverter defibrillator lead, and dual chamber ICD.  We billed 33233, 33234, 33249.  I am not showing any of these need modifiers??  

Any help would be appreciated!


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## kmuerth (Mar 19, 2015)

those codes are correct. No modifiers needed unless this was done in the post op period of something else.


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## Misty Dawn (Mar 20, 2015)

denisek1028 said:


> Patient upgraded from dual chamber pacemaker to dual chamber ICD.  Physician removed right ventricular pacing lead, dual chamber pacemaker, implanted dual coil implantable cardioverter defibrillator lead, and dual chamber ICD.  We billed 33233, 33234, 33249.  I am not showing any of these need modifiers??
> 
> Any help would be appreciated!




I agree with your codes.  Per CPT and Heart Rhythm society coding book you add a 51 modifier.  
33249
33234.51
33233.51
Some payers, including Medicare contractors, do not acknowledge modifier 51. Check your payer policy.


Misty Sebert CPC, CCC, CCVTC
The Coding Network, LLC
www.linkedin.com/in/mistysebertcardiologycoder


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## j.monday7814 (Mar 23, 2015)

and DFT testing for the ICD? 93641...our physicians always perform DFT testing during ICD procedures. all other codes look correct


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