Cardiology Coding Alert

You Be the Coder:

Pacemaker and ICD Implantations

Question: Are codes 75820 and 36005 bundled into a pacemaker (PM) and implantable cardioverter defibrillator (ICD) implantations?

Kansas Subscriber

Answer: The National Correct Coding Initiative does not now include 75820 (Venography, extremity, unilateral, radiological supervision and interpretation) and 36005 (Injection procedure for extremity venography [including introduction of needle or intracatheter]) with pacemaker and implantable cardioverter defibrillator procedures.
For example, if your cardiologist performs a left upper-extremity venogram with contrast into the peripheral IV located in the hand, you would include 36005-52 for the injection of the contrast during the venography and 75820 for your radiological supervision and interpretation. Because 36005 includes both access and injection, you must append modifier -52 (Reduced services) to indicate that you injected contrast into an existing IV and therefore didn't introduce the needle.
Note: Remember to append modifier -26 (Professional component) to 75820 if you perform the service in the hospital, because the hospital will also report 75820 to reflect the fact that you used hospital-owned equipment.
Heads-up: When you report these services, you are indicating that the cardiologist performed a diagnostic study. This may be necessary when the doctor experiences intravenous blockages after attempting to advance the electrode(s) for the pacemaker or defibrillator. You should not report this service if the cardiologist is performing routine injections simply to guide his advancement of the electrode(s).

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