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Wiki Coding PM upgrade to ICD w/ LV lead

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deeva456

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I need a 2nd opinion on how to code upgrading a pacemaker to ICD generator with an LV lead.

The physician billed for removal of the pacemaker generator, RV lead and LV lead insertion. The codes he selected are: 33233, 33216 and 33224. The codes I selected are: 33233 - PM generator removal, 33249 ICD implant, single or dual lead and 33225 - LV lead. The physician explained that he was taught to use 33233, 33216 & 33224. In what scenario is 33224 billed? I use Dr. Z's Medical coding reference for cardiology but it does not give any information how to use this code.

Thank you for your help.

Dolores
 
PM upgrade to ICD with LV lead.

You are completely correct in your code assignment and your provider, despite being obviously very intelligent, is like a lot of providers.....they think they are expert coders. I wonder who told them to use those codes.

33249, 33225, 33233 are correct.

33224 is for insertion of an LV lead to a previously placed pacer or ICD generator. In coding EP for 5 years I don't think I ever used the code. You will probably never use it either.
 
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