Cardiology Coding Alert

Question: My cardiologist removed an ICD lead, replaced it with a new one, and then tested it after he hooked the lead up to the generator. Which codes should I use for this?

New York Subscriber

Answer: Although you need to provide more information to receive the accurate codes, generally you would report the:

• removal of the old lead with 33244 (Removal of single or dual chamber pacing cardioverter-defibrillator electrode[s]; by transvenous extraction)

• implantation of the new lead with 33216 (Insertion of a transvenous electrode; single chamber [one electrode] permanent pacemaker or single chamber pacing cardioverter-defibrillator).

• necessary fluoroscopy with 71090-26 (Insertion pacemaker, fluoroscopy and radiography, radiological supervision and interpretation; Professional component).

Don't miss: Your cardiologist probably performed an EP study to test the defibrillation threshold of the device and to confirm it was implanted and programmed appropriately.

For this service, you should report 93641-26 (Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation [induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination] at time of initial implantation or replacement; with testing of single or dual chamber pacing cardioverter-defibrillator pulse generator; Professional component).