aussome1
New
I have a physician that has started to put HIS Bundle Leads in when he does a pacemaker. When we looked in our cardiac rhythms book it directed us to bill an unlisted code for the HIS Bundle. It doesn't give any information as to whether we should bill this as a 33207 (single lead) or 33208 (dual lead) PPM. Typically he only does this as a HIS bundle and LV Coronary Sinus (33225). We have been billing this as a 33207 - KX with a 33225. We are wondering if we are billing it correctly this way?
We did a left arm venogram. Following this, we cannulated the left axillary vein. Under fluoroscopy, we inserted a Medtronic 3830 lead at the His bundle areas and nice His potential was recorded. The QRS was narrow with the pacing threshold 2.2 volts at 1 millisecond. Impedance of 586 ohms. R waves 1.8 millivolts. Then, we cannulated the coronary sinus and positioned LV lead into the anterolateral branch of LV lead. It is a Medtronic 4298 lead. Impedance of 1483 ohms, R wave was 6.6 millivolts. The pacing threshold was 1 volt at 0.5 milliseconds. After the lead was secured pocket was irrigated with bacitracin. The lead was connected to Medtronic Percepta biventricular pacemaker pulse generator. Serial # was RNP211730 H. Pocket was closed up with 2-0 Vicryl continuous suture layer from a deeper layer to superficial layer. Sterile strips applied. Patient tolerated the procedures well. |