Cardiology Coding Alert

Question: Which diagnosis code should I use for a pacemaker battery change when the battery stops working?

Georgia Subscriber

Answer: The most appropriate code for replacement at the end of the expected battery life is V53.31 (Fitting and adjustment of cardiac pacemaker). Under ICD-10-CM, you'll use Z45.010 (Encounter for checking and testing of cardiac pacemaker pulse generator [battery]), which applies to replacing the battery according to a note with the code.

But if the battery, also called a pulse generator, breaks down before the end of its expected life, then 996.01 (Mechanical complication due to cardiac pacemaker [electrode]) is more appropriate. The ICD-10-CM equivalent is T82.111- (Breakdown [mechanical] of cardiac pulse generator [battery]). You'll add a seventh character to specify the encounter:

• A, Initial encounter

• D, Subsequent encounter

• S, Sequela.

Caution: For coverage, payers may require a code explaining why the patient has a pacemaker, such as sick sinus syndrome ICD-9 code 427.81 (Cardiac dysrhythmia; sinoatrial node dysfunction) or ICD-10 code I49.5 (Sick sinus syndrome).

Procedure: When the cardiologist replaces only the generator, report the appropriate code from 33227-33229 (Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator ...).