Anesthesia Coding Alert

Question: Which CPT Codes and ICD-9 codes apply to changing a pacemaker battery?

Washington Subscriber

Answer: A pacemaker battery is known as a pulse generator. You report it based on the type of generator: 33212 (Insertion or replacement of pacemaker pulse generator only; single chamber, atrial or ventricular) for a single chamber or 33213 (... dual chamber).
 
If you're coding for anesthesia during the procedure instead of the replacement itself, report 00530 (Anesthesia for permanent transvenous pacemaker insertion).
 
The diagnosis for pacemaker replacement depends on what led to the procedure. Some coders say that end of battery life is considered a mechanical breakdown, so report 996.00 (Mechanical complication of cardiac device, implant, and graft; unspecified device, implant, and graft). Others recommend 996.72 (Other complications of internal [biological] [synthetic] prosthetic device, implant and graft; due to other cardiac device, implant and graft) instead. Review the case with the physician to determine the best ICD-9 code.