Carriers Hold Claims for Codes 33249, C1882

The Centers for Medicare & Medicaid Services (CMS) has instructed fiscal intermediaries (FIs) and Medicare administrative contractors (MACs) to hold claims for the device described by HCPCS Level II code C1882 Cardioverter-defibrillator, other than single or dual chamber (implantable) when reported with the procedure described by CPT® code 33249 Insertion or replacement of permanent pacing cardioverter-defibrillator system with transvenous lead(s), single or dual chamber.

Only Medicare claims containing both C1882 and 33249 with dates of service between Jan. 1, 2012 and June 30, 2012 are affected.

CMS recently discovered that the procedure-to-device edit files included in the January 2012 (V13.0) and April 2012 (V13.1) Integrated Outpatient Code Editor (I/OCE) do not allow C1882 to satisfy the edit in place for 33249.

According to CMS, the July 2012 I/OCE (V13.2) will be updated with a new procedure-to-device edit file that will allow HCPCS Level II code C1882 to be billed with CPT® code 33249, and carriers will begin processing held claims beginning July 2, 2012.

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