Cardiology Coding Alert

Don't forfeit $500 for unreported work

With no CPT code for left ventricular (LV) lead removal, you may be considering writing off this service to avoid hassles with unlisted-procedure code. Before you give up, consider billing electrode removal codes 33234 or 33235 for this service.
 
Typically, you would report 33234 (Removal of transvenous pacemaker electrode[s]; single-lead system, atrial or ventricular) when the physician removes atrial or ventricular pacemaker electrodes from a single-lead system. And you would report 33235 (... dual-lead system) if the cardiologist removed an atrial or ventricular electrode from a dual-lead system.

New method: The North American Society of Pacing and Electrophysiology (NASPE) is recommending that you report 33234 or 33235 as appropriate for left ventricular lead removal, says Brian Outland, NASPE spokesman.

These code descriptions fit the LV lead removal service, Outland says. Keep in mind, however, that there are more chances with the LV lead removal for something to go wrong. This means that coders may need to append modifier -22 (Unusual procedural services) to 33234/33235 to indicate that the procedure was especially complex and involved extra physician work, he says. Remember to attach detailed documentation regarding the procedure's unusual nature if you append modifier -22, he says.