Wiki Failed ICD changeout coding help needed!

[sdodson]

Our Dr. was going to remove the existing ICD and replace with a dual chamber ICD with insertion of pacing lead. After removing the old generator he tried to insert the new lead to no avail. He performed a venogram on the subclavian vein and found it to be stenosed and tortuous. After almost 5 hours of trying various techniques to advance the new lead, he gave up and placed the old ICD back into the pocket after reattaching the existing leads. What can we bill? Thanks in advance.

 

[twizzle]

Our Dr. was going to remove the existing ICD and replace with a dual chamber ICD with insertion of pacing lead. After removing the old generator he tried to insert the new lead to no avail. He performed a venogram on the subclavian vein and found it to be stenosed and tortuous. After almost 5 hours of trying various techniques to advance the new lead, he gave up and placed the old ICD back into the pocket after reattaching the existing leads. What can we bill? Thanks in advance.

Probably just the new lead insertion with a modifier 52, and the venogram with Dx 459.2.
I guess you can't really bill the generator removal although technically he did remove it, but in circumstances when a generator is taken out and then reinserted it is not billed.

He definitely needs to be paid something for his troubles.
33216-52, 36005-59, 75820-26(LT or RT).

Any other views?

 

[sdodson]

Thanks!