# 33282 and 33284 same session is it billable with 59 modifier?



## bhargavi (May 1, 2018)

Cardiac Implantable Loop Monitor Explant Operative Report
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Procedure(s): Implantable Loop recorder explantation
Implantable Loop recorder implantation
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Indications: 
Loop ERI
Palpitations
Cryptogenic stroke
PAT
Inducible but not clinical PAF
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Procedure Details
The risks, benefits, complications, treatment options, and expected outcomes were discussed with the patient. The patient and/or family concurred with the proposed plan, giving informed consent. Patient was marked and timeout done.
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The antibiotic was completely infused.  The patient was prepped and draped in the usual sterile fashion and the left lower parasternal region anesthetized with 10 cc of 2% lidocaine with epinephrine.  An incision was made over the old scar, and dissection made down to the loop device, and the pocket incised and loop removed.  The insertion tool of the new device inserted the loop parallel to the old loop pocket in a new site.   Hemostasis was insured. The incision was closed with steristrips.  
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 Steri-Strips and a dry sterile dressing were placed over the wound and the patient was transferred to the heart center holding room in stable condition for recovery from sedation.
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I was present with the patient for the duration of moderate sedation and supervised airway monitoring staff who had no other duties and monitored the patient for the entire procedure.  Details of sedation and monitoring are entered by the nurse administering the sedation into the EP lab EMR.  Please see the nursing flow sheets for documentation of the name of the independent trained observer, and intra-service start and end times.
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Hardware explanted:  Medtronic Reveal LINQ MN LNQ11, SN RLA685634S
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Hardware implanted:  Medtronic Reveal LINQ MN LNQ11, SN RLA497302S
should I bill 33282-59,33284?
patient has medicare
thanks in advance
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## theresa.dix@tennova.com (May 3, 2018)

bhargavi said:


> Cardiac Implantable Loop Monitor Explant Operative Report
> *
> Procedure(s): Implantable Loop recorder explantation
> Implantable Loop recorder implantation
> ...



Yes code with a 59 modifier


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## Ape (May 8, 2018)

Yes also the modifer XU is appropriate instead of the 59.


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