Cardiology Coding Alert

Question: Which ICD-9 code should we use when a pacemaker battery dies?

Oklahoma Subscriber

Answer: If you're coding battery replacement at the expected end of battery life, the most appropriate code is V53.31 (Fitting and adjustment of other device; cardiac pacemaker).

But if the battery, also called a generator, stops working before the end of its expected life, then 996.01 (Mechanical complication of cardiac device, implant, and graft; due to cardiac pacemaker [electrode]) is more appropriate.

Reason: Code 996.01 is specific to complications, and a battery that stops functioning at the end of its expected life is experiencing an expected occurrence, not a complication.

Reality check: Payers may require additional diagnoses for coverage. For example, check your local coverage determinations to see if the payer requires a code explaining why the patient has a pacemaker, such as 427.81 (Cardiac dysrhythmia; sinoatrial node dysfunction).

CPT: Link the appropriate ICD-9 codes to either 33212 (Insertion or replacement of pacemaker pulse generator only; single chamber, atrial or ventricular) for a single chamber or 33213 (... dual chamber) for a two chamber device.