Wiki temp & perm pacemaker! Help Please

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ljrj0721

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Local Chapter Officer
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Ninety Six, SC
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Good Afternoon!
I have a pt that came into the Er with complete AV block, bryadycardia & syncope. We admitted pt and also put in a temp pacer. The following day the pt was taken to the cath lab and dual chamber pacer was put in. during procedure pt's BP went up, he developed cardiogenic shock and had to be resucitated. Not sure exactly how to code.
Admit charge is 99223
Temp Pacer is 33210 this was on 10/27/13

Dual pacer is 33208
Critcal Care is 99291 this was following day
Can I code critcal care in the cath lab and I know I need to use modifiers
25, 57, and I would like to use mod 22 due to the problems encountered in the cath lab. Spent approx 45 min with pt in cath lab and this excludes the pacemaker implant.

Thanks for any and all help.
 
For what you have listed I would bill

99223-25-57 and 33210 for 10/27/13

33208 and 99291-24 for the 10/28/13

I would not use the 57 modifier on the CC as the decision for pacermaker was made the day prior. I would not use the 22 modifier as the time documented excluding pacemaker implant would be your CC time.

Just my opinion.....

HTH! :)
 
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