I realize the NCD 20.8.3 for Pacemaker implants CR9078 states the syncope (R55) is not a covered dx for pacemaker implants. It also goes on to state that claim will be denied if R55 is present even with a qualifying covered DX code. I have some concerns regarding this and I am curious if any one else have any other information. Our billing dept. is removing dx codes from patient that have had a Pacemaker implant and R55 is listed on the claim. In some cases this code is also being removed fro the Admitting DX for the patients encounter. All pacemaker patients have the correct indications and the correct dx codes for the procedure. However some of these patients did have a syncopal event in addition to other indications. I am concerned that this dx codes are being removed from the patient's encounter to bill a pacemaker back should they not remain if the patient truly had these events. I am curious if any one have any additional information