Cardiology Coding Alert

Question: The cardiologist documented testing pacemaker leads using fluoroscopy (71090) in the hospital. Which code is appropriate for the testing? New Hampshire Subscriber Answer: You mention 71090 (Insertion pacemaker, fluoroscopy and radiography, radiological supervision and interpretation), which is specific to radiological supervision and interpretation at the time of device insertion. So presumably the cardiologist was testing the leads at the time the patient first received the pacemaker. You can't report lead evaluation separately at the time of pacemaker insertion (such as 33206-33208). Verify device: Doctors sometimes document "pacer" when referring to a pacing automatic internal cardioverter defibrillator (AICD), so confirm which device the cardiologist is referring to. You may report one of the following two codes for evaluating leads at the time of an AICD insertion: • 93640-26 -- Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing [...]