Virginia Subscriber
Answer: Modifier -79 (unrelated procedure or service by the same physician during the postoperative period) should be appended to 93642 (electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator [includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parameters]) to indicate that the evaluation of the defibrillator is separate from the implantation procedure, i.e., unrelated. Similar to 93641 (... with testing of single or dual chamber pacing cardioverter-defibrillator pulse generator) the code used to describe the evaluation that was attempted, then discontinued on the day of the implantation 93642 is payable separately because evaluation of pacers or internal cardioverter-defibrillators is considered unrelated to the implantation of these devices.
The answers to You Be the Coder and Reader Questions were provided by Sueanne Bicknell, RRA, CPC, CCSP, compliance administrator with CPR/Heart Place, a 60-physician practice in Dallas; Susan Callaway, CPC, CCS-P, a coding and reimbursement specialist and educator in North Augusta, S.C.; Kathleen Mueller, RN, CPC, CCS-P, a coding and reimbursement specialist in Lenzburg, Ill.; Sandy Rubio, RN, CPC, a cardiology coding and reimbursement specialist in Omaha, Neb.; Nikki Vendegna, CPC, a cardiology coding and reimbursement specialist in Overland Park, Kan.; and Marko Yakovlevitch, MD, FACP, FACC, a cardiologist in private practice in Seattle.