Wiki Denial of pacer 33208 with 427.89 dx

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sandya

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Hi...anybody getting denials for a dual pacer 33208 with bradycardia 427.89 as the main diagnosis? KX modifier was applied. The records confirm "symptomatic bradycardia" with secondary dx of sinus node dysfunction. Any suggestions on how to get this paid? This is a very common reason for a pacer. thanks Sandy:)
 
Check the CMS guidelines. I don't have the latest one in front of me, but 427.89 is not on the list of covered diagnoses. I believe the guidelines were updated effective 7/1/2015 and I know some diagnoses were added, but like I said, I don't have the latest guidelines in front of me.
 
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