Cardiology Coding Alert

Reviewed on May 22, 2015   Test your coding knowledge. Determine how you would code this situation before looking at the box below for the
answer.
Question: Which ICD9 Code should be used for a pacemaker battery change when the instrument has stopped working? Florida Subscriber   Answer: The most appropriate code for replacement at the end of the expected battery life is V53.31 (Fitting and adjustment of cardiac pacemaker). Under ICD-10-CM, you’ll use Z45.010 (Encounter for checking and testing of cardiac pacemaker pulse generator [battery]), which applies to replacing the battery according to a note with the code.   But if the battery, also called a pulse generator, breaks down before the end of its expected life, then 996.01 (Mechanical complication due to cardiac pacemaker [electrode]) is more appropriate. The ICD-10-CM equivalent is T82.111- (Breakdown [mechanical] of cardiac pulse generator [battery]). You’ll add a seventh character to specify the encounter: A, Initial encounter D, Subsequent encounter S, Sequela. Caution: For coverage, payers may require a code explaining why the patient has a pacemaker, such as sick sinus syndrome ICD-9 code 427.81 (Cardiac dysrhythmia; sinoatrial node dysfunction) or ICD-10 code I49.5 (Sick sinus syndrome).   Procedure: When the cardiologist replaces only the generator, report the appropriate code from 33227-33229 (Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator …).