Wiki Coding PM upgrade to ICD w/ LV lead

[deeva456]

I need a 2nd opinion on how to code upgrading a pacemaker to ICD generator with an LV lead.

The physician billed for removal of the pacemaker generator, RV lead and LV lead insertion. The codes he selected are: 33233, 33216 and 33224. The codes I selected are: 33233 - PM generator removal, 33249 ICD implant, single or dual lead and 33225 - LV lead. The physician explained that he was taught to use 33233, 33216 & 33224. In what scenario is 33224 billed? I use Dr. Z's Medical coding reference for cardiology but it does not give any information how to use this code.

Thank you for your help.

Dolores

 

[twizzle]

PM upgrade to ICD with LV lead.

You are completely correct in your code assignment and your provider, despite being obviously very intelligent, is like a lot of providers.....they think they are expert coders. I wonder who told them to use those codes.

33249, 33225, 33233 are correct.

33224 is for insertion of an LV lead to a previously placed pacer or ICD generator. In coding EP for 5 years I don't think I ever used the code. You will probably never use it either.