Wiki 33225 + ?

[Jess1125]

Okay,

The patient I'm working on had a single chamber ICD and was brought in for an upgrade to a Bi-V ICD.

The existing RV lead was left in place and a new LV lead was inserted as well as the old generator explanted and a new one placed.

I know to report the 33225 but I'm wondering about the generator change out code. I guess I feel that it would be 33263 because only 2 chambers are now being paced, the RV/LV.

My doctor circled the 33264 for multiple. I don't feel that that might be correct? Can someone please help as I'm new to the EP world. Only been doing EP for a few months now.

Jessica CPC, CCC

 

[jewlz0879]

I agree with you. I'm wondering if the doc picked 33264 since he did the "Bi-v upgrade," a lot of times that means (at least in my experience with my physicians) the patient already has a dual chamber system, then the LV lead is placed, therefore making it a multiple system.

Since this patient only has the two leads I would go with your code selection of 33263. "Multiple Lead," by CPT definition means: a PM or ICD with pacing and sensing function in three or more chambers of the heart.

HTH

 

[Jess1125]

I agree with you. I'm wondering if the doc picked 33264 since he did the "Bi-v upgrade," a lot of times that means (at least in my experience with my physicians) the patient already has a dual chamber system, then the LV lead is placed, therefore making it a multiple system.

Since this patient only has the two leads I would go with your code selection of 33263. "Multiple Lead," by CPT definition means: a PM or ICD with pacing and sensing function in three or more chambers of the heart.

HTH

Thanks, glad you agree. I'll query physician.
Jessica CPC, CCC