Cardiology Coding Alert

Question: Is a temporary pacemaker placement included in 93650 or may I code it separately?

Hawaii Subscriber

Answer: Yes, placement of a temporary pacemaker is included within 93650 (Intracardiac catheter ablation of atrioventricular node function, atrioventricular conduction for creation of complete heart block, with or without temporary pacemaker placement), and no, you should not report temporary pacemaker placement the cardiologist performs at the same time as an ablation.

Code 93650 is specific to ablative procedures the cardiologist performs to destroy the atrioventricular node. Since the descriptor states "with or without temporary pacemaker placement," you may report 93650 whether the provider places a temporary pacemaker or not.

Note: Although you should not report temporary pacemaker placement separately, you can report a permanent pacemaker placement separately.

Heed CCI edits: According to the 2017 Correct Coding Initiative (CCI) edits, 33210 (Insertion or replacement of temporary transvenous single chamber cardiac electrode or pacemaker catheter [separate procedure]) and 33211 (Insertion or replacement of temporary transvenous dual chamber pacing electrodes [separate procedure]) are bundled into 93650. You cannot override the edits under any circumstance, since they have a modifier indicator of 0.