Cardiology Coding Alert
Find Codes for BiV Upgrade
Question: If a patient has an upgrade from dual to BiV PM at the same session that the atrial lead was capped and left in the pocket, and a new atrial lead was attached, what would the coding be?
Answer: This sort of upgrade requires replacing the pulse generator, so the physician should include that step in his report. Code the pulse generator removal using 33233 (Removal of permanent pacemaker pulse generator only).
Report the placement of a new pacemaker system with atrial lead placement using 33206 (Insertion of new or replacement of permanent pacemaker with transvenous electrode[s]; atrial). Capping the lead should not be reported separately.
Be sure to add the placement of the new ventricular lead (the upgrade to BiV, or biventricular) using +33225 (Insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertion of pacing cardioverter-defibrillator or pacemaker pulse generator [e.g., for upgrade to dual chamber system] [List separately in addition to code for primary procedure]).
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Cardiology Coding Alert
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