Cardiology Coding Alert

Question: If the cardiologist repositions and reconnects a dislodged transvenous, right ventricular lead of a dual-chamber pacemaker or defibrillator device for one of her patients during the postoperative period, how should I report this? Pennsylvania Subscriber Answer: The appropriate code for repositioning is 33215 (Repositioning of previously implanted transvenous pacemaker or pacing cardioverter-defibrillator [right atrial or right ventricular] electrode). Modifier must: Because you mention that the service was during the postoperative period, you should consider appending modifier 78 (Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period). Be sure the service meets four requirements before you append this modifier: 1. The same physician performed the original procedure (such as 33208, Insertion or replacement of permanent pacemaker with transvenous electrode[s]; atrial and ventricular) and subsequent procedure (33215,repositioning) 2. The subsequent procedure occurs within the global period of the initial [...]