Cardiology Coding Alert

Plus: Don't miss whether guidelines trump CPT® tables.

As you apply the new pacemaker codes in 2012, pay attention to code definitions to help you determine which codes you may report together.

Case in point: Read the code definition of 33214, which remains the same as it was in 2011: Upgrade of implanted pacemaker system, conversion of single chamber system to dual chamber system (includes removal of previously placed pulse generator, testing of existing lead, insertion of new lead, insertion of new pulse generator).

The definition clearly states that the code includes removing the previously placed pulse generator and inserting a new pulse generator. So it should come as no surprise that CPT® 2012 adds a note with 33214 that you should not report the code with new generator replacement codes 33227-33229 (Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator ...).

Bonus tip: CPT® 2012 includes a table to help explain proper use of the new codes, but keep in mind, "As always, the introductory language and code descriptions provided supersede any table information; if you have a question, please refer to those," said Kenneth P. Brin, MD, PhD, FACC, of the CPT® Editorial Panel, and James Blankenship, MD, MACC, FSCAI, of the Relative Value Update Committee, at the CPT® and RBRVS 2012 Annual Symposium Cardiology Services Update.