Wiki Dual Chamber ICD

[Chelsea1]

Pt recieved Dual Chamber ICD (33249) with Defib testing (93641). Can I also bill 36005 for "A 10 milliliter venogram was performed and access into the lateral axillary vein was performed? If so, where would I be able to find the information regarding this?
Thanks for any help!!!!

 

[Ginger Avery]

The 36005 is bundled into the 33249 with an indicator 1. Therefore, if it is truly a separately reportable procedure, then reporting it with the corresponding "X" (XE, XS, XP, XU) modifier would be appropriate. When they perform this in our OR, it is generally bundled into the primary procedure and not seperately reportable.

 

[Chelsea1]

I appreciate it. ? on where to find the information stating that it is bundled

Thanks

 

[j.monday7814]

the details under the beginning of the pacemaker or ICD header go into detail about fluoro guidance and how it is included in almost all PM/ICD procedures. 36005 is part of that fluoro guidance, you can't bill for placing a catheter to image the vein to place a lead, all of that is bundled.

also, we use Optum Encoder Pro which details all included and excluded services for every procedure so you know exactly what you can and cannot bill with each procedure

 

[twizzle]

Pt recieved Dual Chamber ICD (33249) with Defib testing (93641). Can I also bill 36005 for "A 10 milliliter venogram was performed and access into the lateral axillary vein was performed? If so, where would I be able to find the information regarding this?
Thanks for any help!!!!

A situation where you might use 36005 is when the surgeon has difficulty placing a lead, particularly if the vein is tortuous or has a blockage. In those cases you can unbundle it with the appropriate modifier. Dx code 459.2 is for compression of a vein and is the one to use with 36005. Don't forget to also report 75820-26 for S&I of the venogram.
Routinely billing 36005 is termed road-mapping when the surgeon does it to merely look at the veins prior to inserting the device.
Hope this helps.