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Cardiology Coding Alert

Reader Question:

Report Reduced Services for No Skin Pocket

Published on Mon Oct 27, 2003

Question: How should we bill for a pacemaker procedure when our physician inserted the pacemaker and leads, but a different doctor created the surgical pocket?

Arizona Subscriber Answer: You should report 33208-52 (Insertion or replacement of permanent pacemaker with transvenous electrode[s]; atrial and ventricular) for the procedure and append modifier -52 (Reduced services). Skin pocket development is part of the pacemaker implant. And if another doctor performed that portion of the procedure, the service provided by the billing physician would be slightly reduced.
 
You should also report 71090-26 (Insertion pacemaker, fluoroscopy and radiography, radiological supervision and interpretation; professional component) for the fluoroscopy during the pacer insertion, assuming your physician performed and documented this.
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