Home Health ICD-9/ICD-10 Alert

Question: When a patient has a "pacemaker with defibrillator," should we list V45.01 (Cardiac device in situ; cardiac pacemaker) and V45.02 (Cardiac device in situ; automatic Implantable Cardioverter Defibrillator), or does V45.02 cover it all?

Answer: For now, you'll need to report both V45.01 and V45.02 to describe a patient who has a pacemaker with a built in defibrillator.

But watch for upcoming ICD-9 changes that will alter the way you'll code this situation. During their March meeting, the ICD-9-CM Coordination and Maintenance Committee Meeting proposed making changes to both V45.01 and V45.02 to address just the issue you bring up.

Recognizing that new defibrillators also have pacemaker capabilities, the committee proposed adding the term "defibrillator with pacing capability" to the excludes note at V45.01. The committee also discussed modifying the inclusion term for V45.02 to read "with pacing capability" at code V45.02.

Also under consideration is a proposal to exclude the cardiac pacemaker status code from the defibrillator status code. We'll keep you updated on these proposed changes in future issues of Home Health ICD-9 Alert.