Cardiology Coding Alert

Question: My cardiologist is changing the patient's pacemaker battery. What diagnosis code should I use?
Montana Subscriber

Answer: In an ideal world, you should use V53.31 (Fitting and adjustment of cardiac pacemaker) but unless this code is included in your payer's specified coverage indication, you may face a denial.

For instance, you won't find this ICD-9 code currently listed in CMS's national coverage determination (NCD) on cardiac pacemakers, available at www.cms.hhs.gov/mcd/index_list.asp?list_type=ncd.

What to do: Investigate your cardiologist's documentation for the medical reason why the patient requires the device (such as bradychardia or heart block).

Link this diagnosis to either 33212 (Insertion or replacement of pacemaker pulse generator only; single chamber, atrial or ventricular) for a single chamber or 33213 (... dual chamber).

Watch out: You should not consider changing a battery as a mechanical complication (996.00, Mechanical complication of cardiac device, implant, and graft; unspecified device, implant, and graft; or 996.72, Other complications of internal [biological] [synthetic] prosthetic device, implant and graft; due to other cardiac device, implant and graft). Changing the battery is an expected occurrence. A mechanical complication means an event: for instance, the lead failed or the manufacturer recalled the battery.