Failed upgrade to Bi-V from AICD

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16
Location
Bentonville, AR
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0
I am struggling with this procedure. It was a failed procedure but modifier 53 and 52 are not allowed to be billed with the 33224. I have copied the procedure note below...any advice would be appreciatated.

Thank you

Kim Floyd, CPC

The patient has congestive heart failure, class III with
dilated cardiomyopathy of less than 25% with QRS above 130. Risks,
benefits, alternatives, gross possible complications, need for team
approach were discussed with the patient and her daughters, and
informed consent was obtained.

A 6-cm incision was made into the left pectoral area with blunt and
sharp dissection. I freed the AICD leads as well as the
defibrillator. I accessed the left axillary vein and advanced
initially a CPS 35 cm then used a CPS wide, then CPS straight through
the procedure, and we tried to advance a QuickFlex 1258T/86 cm micro
into the coronary sinus. the angiography of the coronary sinus in
multiple views showed only 1 very large suitable lateral vein that
was very tortuous. I was not able to stabilize the lead in a
suitable location. After more than 60 minutes of fluoro time, I
decided to stop. The defibrillator was placed back into the pocket,
and the incision closed with 2-0 Vicryl x3 layers and skin staples.

PLAN We will consult CT surgery for possible epicardial lead and
upgrade to Bi-V.
 
Messages
16
Location
Bentonville, AR
Best answers
0
Figured it out and in case anyone wants to know...in this example the venogram would be charged since the 52 and 53 aren't allowed with 33224

75820,26
36005
 
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