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 SubscriberAnswer: 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).