Cardiology Coding Alert

Question: Our physicians frequently place temporary pacemakers during heart catheterizations. Should we report these separately?

Ohio Subscriber

Answer: In many cases, a physician will place a temporary pacemaker as a prophylactic measure to prevent arrhythmias during cardiac catheterizations. Specifically, the physician will place a pacing-electrode-tipped catheter to prevent abnormal heart rhythms that might be triggered by the catheterization. In these instances, you should not bill separately for the temporary pacemaker.

But if the physician places the temporary pacemaker in response to an abnormal rhythm that arises, he or she can bill for it separately. Make sure you add modifier -59 (Distinct procedural service) and report the diagnosis that reflects the abnormal rhythm with the pacemaker code because this may be necessary to reflect its necessity as separate from that of the heart cath.