Wiki Dual ICD upgrade to Bi-V ICD w/new lead

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HEMINGWAYT

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Local Chapter Officer
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Plattsburgh, NY
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Hi,
Can I get some help with this situation:

Existing dual chamber ICD is explanted, the atrial lead is capped due to dysfunction. A new atrial lead is implanted, a new LV lead is implanted and a new BI-V ICD generator is implanted and connected to all three leads. We have coded 33241 for removal of ICD generator, 33249 for insertion of ICD w/lead single or dual chamber and 33225 for insertion of left ventricular lead. Is this correct?

Thanks in advance,
 
In this situation I belive your primary code should be 33264 for the removal of the old generator and the implantation of the new multiple lead system. Then I agree you should use the +33225 for the insertion of the left ventricular lead. I belive you could also then use code 33216 for the insertion of the new atrial lead.
 
HEMINGWAYT said:
Hi,
Can I get some help with this situation:

Existing dual chamber ICD is explanted, the atrial lead is capped due to dysfunction. A new atrial lead is implanted, a new LV lead is implanted and a new BI-V ICD generator is implanted and connected to all three leads. We have coded 33241 for removal of ICD generator, 33249 for insertion of ICD w/lead single or dual chamber and 33225 for insertion of left ventricular lead. Is this correct?

Thanks in advance,
Click to expand...

You are correct. The other suggestion to use 33264 is not correct as a new atrial lead is placed, therefore 33249,33225,33241(and 93641-26 if testing was done).
 
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