Cardiology Coding Alert

Question: If the cardiologist performs a pacemaker insertion in the hospital and later visits the patient in observation, should I code the observation visit? Georgia Subscriber Answer: You should not charge this visit separately. Pacemaker insertion code 33208 (Insertion or replacement of permanent pacemaker with transvenous electrode[s]; atrial and ventricular) has a 90-day global period. For payers applying Medicare rules, that means that payment for the pacemaker insertion service includes the following services (among others) for 90 days following the procedure: • Services related to complications following surgery, not requiring additional trips to the operating room • Postoperative visits (follow-up visits) related to recovery from the surgery • Postsurgical pain management by the surgeon. FYI: Medicare specifies certain visits that are not included in the global package, meaning you may report them separately: • Visits unrelated to the diagnosis that prompted the surgical procedure (unless the visits occur due to [...]