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Ettrsmith

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My EP Dr. implanted a BiV AICD but had to do a PTA on the Coronary Sinus to get the BiV lead in. the old code 35476 of course has been deleted and they give 37246,+37247; 37248,+37249. 246 is artery, 248 is vein but they read different in the paragraph than the code description. HELP!!

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If your Dr. implanted a new ICD system and new LV lead, I would code it as 33249 and 33225. Per a Dr. Z reference book I have, the venoplasty is not reportable if it is done to "stretch" the vessel to accommodate the large LV lead. Also, it says the AMA has recommended that venoplasty of the coronary sinus branch is only reportable when the PTCA is performed in a vessel other than the destination branch of the LV lead. If this is the case, then you would use CPT 37248...albeit very rare.

Hope this helps.
 
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