Cardiology Coding Alert
Append Modifier -59 for Temporary Pacemaker
Question: Our cardiologist performed a left-heart catheterization (LHC) on a patient. During the procedure, he inserted a temporary pacemaker. The report reads as follows: "Along with reperfusion, the patient developed marked bradyarrhythmias. He was given 1 milligram of atropine, and a temporary pacemaker was placed. Ability to capture was verified, but the pacemaker did not have to be used afterward." Should we bill for the pacemaker? Answer: You can bill for the temporary pacemaker because the patient was having a problem (for example, bradyarrhythmias, 427.89). To indicate that the insertion of the temporary pacemaker was distinct from other services performed the same day, append modifier -59 (Distinct procedural service) to the appropriate temporary pacemaker code (33210, Insertion or replacement of temporary transvenous single chamber cardiac electrode or pacemaker catheter [separate procedure]; or 33211, Insertion or replacement of temporary tranvenous dual chamber pacing electrodes [separate procedure]). Report 71090 (Insertion pacemaker, fluoroscopy and radiography, radiological supervision and interpretation) for the imaging.
Rhode Island Subscriber
If the physician inserts the pacemaker as a preventive measure rather than to treat a particular problem, the procedure is bundled with the catheterization, and codes 33210 and 33211 should not be reported separately.
Cardiology Coding Alert
- Keep Tabs on Stent Injuries in Brachytherapy Coding to Avoid Denials
When reporting intracoronary brachytherapy codes, make sure you have documentation supporting the specific coronary artery [...] - Tips for Coding Intracoronary Brachytherapy
For some extra help coding brachytherapy procedures, take a look at the following intracoronary brachytherapy [...] - CCI Update:
New Pacer Codes Bundle Device Implants
Cardiology coders may not be very concerned about the most recent Correct Coding Initiative (CCI) [...] - Interim RVUs for New CPTCodes
Post this handy list, which includes the code descriptions and the current relative value units [...] - Fee Schedule Shows Diagnostic Procedure Reductions
Under the 2003 fee schedule, which CMS published in the Dec. 31, 2002, Federal Register, [...] - You Be the Coder:
Coding Abdominal Aortagram with Runoff
Test your coding knowledge. Determine how you would code this situation before looking at the [...] - Reader Question:
Use Modifier -76 Rather Than Modifier -25 for Restenting
Question: One of our physicians stented a patient's proximal left anterior descending coronary artery (LD) [...] - Reader Question:
Use New Code for Bilateral Iliac Wall Graft Stenting
Question: Do 37205 (Transcatheter placement of an intravascular stent[s], [non-coronary vessel], percutaneous; initial vessel) and [...] - Reader Question:
Append Modifier -59 for Temporary Pacemaker
Question: Our cardiologist performed a left-heart catheterization (LHC) on a patient. During the procedure, he [...] - Reader Question:
Malignant Ventricular Arrhythmia Goes Unspecified
Question: Should I use ICD-9 code 198.89 (Secondary malignant neoplasm of other specified sites) for [...]
