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Wiki Full Pacemaker System and Multiple Leads Extractions

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bcousey26

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Irving, TX
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Hello,

I need coding guidance on a full pacemaker system and multiple lead extractions during a procedure. According to the EP's note:

Laser lead extraction of 4 pacemaker leads
dual chamber pacemaker generator extraction
pocket revision due to fungemia vegetation on the right ventricular leads
JP drain placement
Temporary pacemaker lead implantation.

This one is very difficult, but how do you possibly billed for multiple leads extractions. Might I add modifier -22 to CPT 33235?

Thank you,

Brandi Cousey, CPC
 
There is no additional code for multi lead removal. Our EPs do a fair amount multi lead extraction cases and normally we do not add a 22 modifier to 33235 but in this case you mention the use of a laser as long as your Dr dictated the extra work and use of the laser for extraction (usually like to see time {such as "took 2x longer then normal due to....") I might go ahead with the 22 modifier for this one.
 
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