Would someone please review the below report and verify my codes please?
"The patient was brought to the Cardiac Electrophysiology laboratory in the fasting state and 12 surface leads were monitored. After premedication with antibiotics, then right chest area was prepped and draped in the usual fashion. Local anesthetic was instilled to the left chest region with 1% lidocaine. An incision was made and a subcutaneous pocket was formed. Via percutaneous stick technique, a 7Fr peel-away sheath was inserted into the rt subclavian vein. A single coil screw in lead was advanced to the right ventricle successfully. Another percutaneous stick was performed, a 6 Fr peel-away sheath was insert4ed into the rt subclavian vein and a screw-in lead was placed in the right atrium successfully.
Via a percutaneous subclavian vein access, a 9Fr peel-away sheath was inserted into the rt subclavian vein. The coronary sinus vein was engaged and visualized after contrast injection. CS lead insertion was unsuccessful. Multiple attempts with multiple guiding catheters were unsuccessful. There was a lateral branch that was identified and that was very small. The branch was dilated with a balloon but even then the CS lead could not be advanced.
RA & RV lead testing was performed. Lead parameters as well as make, model and serial number are listed below. Each lead was sutured in place with silk suture and capped. The pocket was flushed copiously with antibiotic solution. The leads were capped and placed in the pocket. The ICD generator was not implanted at this time. The wound was closed with a running stitch of 3-0 Vicryl and the skin was closed with a running subcuticular stitch of 4-0 Vicryl. Steri-strips and a gauze pressure dressing was applied."
Facility coding-
I coded 33217, 33225.74
Can we charge for the lead testing 93640 and the pocket revision 33223 if the device wasn't implanted?
Thanks in advance,
Tammy
"The patient was brought to the Cardiac Electrophysiology laboratory in the fasting state and 12 surface leads were monitored. After premedication with antibiotics, then right chest area was prepped and draped in the usual fashion. Local anesthetic was instilled to the left chest region with 1% lidocaine. An incision was made and a subcutaneous pocket was formed. Via percutaneous stick technique, a 7Fr peel-away sheath was inserted into the rt subclavian vein. A single coil screw in lead was advanced to the right ventricle successfully. Another percutaneous stick was performed, a 6 Fr peel-away sheath was insert4ed into the rt subclavian vein and a screw-in lead was placed in the right atrium successfully.
Via a percutaneous subclavian vein access, a 9Fr peel-away sheath was inserted into the rt subclavian vein. The coronary sinus vein was engaged and visualized after contrast injection. CS lead insertion was unsuccessful. Multiple attempts with multiple guiding catheters were unsuccessful. There was a lateral branch that was identified and that was very small. The branch was dilated with a balloon but even then the CS lead could not be advanced.
RA & RV lead testing was performed. Lead parameters as well as make, model and serial number are listed below. Each lead was sutured in place with silk suture and capped. The pocket was flushed copiously with antibiotic solution. The leads were capped and placed in the pocket. The ICD generator was not implanted at this time. The wound was closed with a running stitch of 3-0 Vicryl and the skin was closed with a running subcuticular stitch of 4-0 Vicryl. Steri-strips and a gauze pressure dressing was applied."
Facility coding-
I coded 33217, 33225.74
Can we charge for the lead testing 93640 and the pocket revision 33223 if the device wasn't implanted?
Thanks in advance,
Tammy