Cardiology Coding Alert

Question: If my cardiologist attempts to place an LV lead and fails, should I report this?

Kentucky Subscriber

Answer: You can, but you must append an appropriate modifier, such as 53 (Discontinued procedure). In other words, the cardiologist chose to terminate the procedure.

Depending on whether the cardiologist tried to add the LV lead to an already implanted device or tried to add the LV lead to a new device, you would apply modifier 53 to one of two codes:

• 33224 -- Insertion of pacing electrode, cardiac venous system, for left ventricular pacing, with attachment to previously placed pacemaker or pacing cardioverter-defibrillator pulse generator (including revision of pocket, removal, insertion and/or replacement of generator), or

• +33225 -- Insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertion of pacing cardioverter-defibrillator or pacemaker pulse generator (including upgrade to dual-chamber system) (list separately in addition to code for primary procedure).

-- You Be the Coder and Reader Questions were prepared with the assistance of Jim Collins, ACS-CA, CHCC, CPC, CEO of the Cardiology Coalition and compliance manager for several cardiology groups around the country; and reviewed by Jerome Williams Jr., MD, FACC, a cardiologist with Mid Carolina Cardiology in N.C.