Wiki Help with Bivent vs Dual lead generator change

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TBaker

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Please help! I have had several reports where the patient has a coronary sinus lead (left ventricular) and a right ventricular lead (or in some cases, atrial lead) and is having just the generator changed. Would you consider this a dual lead or a multi lead generator change?
I can't find any info on how to bill these! Does having a bi-vent system make it a multi lead system even if they only have one other lead?
For pacemakers would this be 33228 or 33229?
For ICD's would this be 33263 ot 33264?
Here is one example: (PT) current system includes Guidant pacemaker generator, model #**, serial #**, implanted on 01/25/2008; ventricular lead is CPI model #**, serial #**, implanted on 01/02/2002; left ventricular lead is CPI model #**, serial #**, implanted on 04/19/2004. (The patient has capped LV lead Guidant model #**, serial #**, implanted on 04/19/2004 and capped). The pacemaker generator had reached at ERI, therefore requires replacement.
Any guidance is greatly appreciated! :)

T. Baker CPC
 
TBaker said:
Please help! I have had several reports where the patient has a coronary sinus lead (left ventricular) and a right ventricular lead (or in some cases, atrial lead) and is having just the generator changed. Would you consider this a dual lead or a multi lead generator change?
I can't find any info on how to bill these! Does having a bi-vent system make it a multi lead system even if they only have one other lead?
For pacemakers would this be 33228 or 33229?
For ICD's would this be 33263 ot 33264?
Here is one example: (PT) current system includes Guidant pacemaker generator, model #**, serial #**, implanted on 01/25/2008; ventricular lead is CPI model #**, serial #**, implanted on 01/02/2002; left ventricular lead is CPI model #**, serial #**, implanted on 04/19/2004. (The patient has capped LV lead Guidant model #**, serial #**, implanted on 04/19/2004 and capped). The pacemaker generator had reached at ERI, therefore requires replacement.
Any guidance is greatly appreciated! :)

Tbaker,
I would consider this dual chamber. In your CPT book it gives definition of single lead,dual lead and multiple lead. My book page 176.

Dual lead is a pacemaker or pacing cardioverter defibrillator with pacing and sensing function in only two chambers of the heart.

Multiple lead is pacemaker or pacing defibrillator with pacing and sensing function in three or more chambers of the heart.

If you have LV lead and RV lead how many chambers are you pacing? 2
Click to expand...
 
agree with the above....don't get the generator replacements codes mixed up with ICD programming/interrogation codes. PM/ICD replacement codes are based on how many leads are being connected to the new device.
 
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