Cardiology Coding Alert

Question: I'm trying to find the code for radiological supervision and interpretation of ICD implant. I can find the one for pacemaker insertion, but which one should I use for ICD insertion?

Colorado Subscriber

Answer: The descriptor for 71090 (Insertion pacemaker, fluoroscopy and radiography, radiological supervision and interpretation) states "pacemaker," but it is the appropriate code to use with ICD (implantable cardioverter-defibrillator) insertion, as well.

CPT Assistant (August 2002) states that 71090 "is intended to be used with pacemakers or cardioverterdefibrillators." Caution: Before you report 71090, be sure the documentation describes the use of fluoroscopic guidance. Statements as simple as "the leads were advanced under fluoroscopic guidance" and "total fluoro time was 55 seconds" should suffice.

Also remember that 71090 has technical and professional components, so you should append modifier 26 (Professional component) if you're reporting only the physician work.