Wiki Replacement of generator and atrial lead

[Summer]

Question: when a physician replaces a generator (from a dual chamber) and capped an existing atrial lead then inserted a new atrial lead which CPT codes should we be using?

Thank you in advance.

 

[dpeoples]

Question: when a physician replaces a generator (from a dual chamber) and capped an existing atrial lead then inserted a new atrial lead which CPT codes should we be using?

Thank you in advance.

Pacemaker or ICD?

 

[Summer]

Pacemaker.

Thanks Danny!

 

[dpeoples]

Question: when a physician replaces a generator (from a dual chamber) and capped an existing atrial lead then inserted a new atrial lead which CPT codes should we be using?

Thank you in advance.

Based on your answer of pacemaker, I would code:

33233 for removal of old pacer pulse generator
33208 for placement of new pulse generator (dual lead/atrial and ventricular), this code inlcudes the new atrial electrode placement.

This is not my primary field, perhaps others will weigh in.

HTH

 

[jsccollins]

Generator Change and New RA Electrode

The proper way to code the case you describe is as follows:

33233 - Removal of permanent pacemaker pulse generator only
33206 - Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial

It is a little goofy appearing at first because the patient is being sent home with a functioning dual chamber pacemaker system. However, the AMA clarified a few years back that we are supposed to use the system implant code that accurately describes the hardware that the doctor personally implanted. In your case, the doctor implanted a generator and a new atrial lead - this is the definition of code 33206. We would not want report 33208 because it would compensate us for the implantation of a generator, a right atrial lead, and a right ventricular lead - auditors would pounce on this as over coding if the report was selected for audit.

Hope this helps; Jim Collins, CPC, CCC - President CardiologyCoder.Com

 

[dpeoples]

The proper way to code the case you describe is as follows:

33233 - Removal of permanent pacemaker pulse generator only
33206 - Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial

It is a little goofy appearing at first because the patient is being sent home with a functioning dual chamber pacemaker system. However, the AMA clarified a few years back that we are supposed to use the system implant code that accurately describes the hardware that the doctor personally implanted. In your case, the doctor implanted a generator and a new atrial lead - this is the definition of code 33206. We would not want report 33208 because it would compensate us for the implantation of a generator, a right atrial lead, and a right ventricular lead - auditors would pounce on this as over coding if the report was selected for audit.

Hope this helps; Jim Collins, CPC, CCC - President CardiologyCoder.Com

That makes sense, thanks for the explanation. Practically speaking it does not matter how many chambers the replacement PG has, only now many leads are placed.