Hcc coding for pacemaker

cakebaker3303

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PHYSICIAN IS CODING FOR Z95.0 PRESENCE OF A PACEMAKER, I WOULD THINK A PACEMAKER WOULD RISK ADJUST. ON THE 2018 HCC LIST IT IS NOT LISTED, BUT CODE: Z95811 Presence of heart assist device 186 Yes, IS ON LIST. I HAVE GOOGLED TO SEE IF A PACEMAKER IS CONSIDERED A HEART ASSIST DEVICE, BUT NO DEFINITIVE ANSWER. DOES ANYONE KNOW? HOPE NOT DUMB QUESTION.
 

rsb2918@aol.com

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If there is a definitive code for a diagnosis you need to go for that code. Pacemaker has it's own code so you need to use the Z95.0
 
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When I was training for my current risk adj coding job, I asked that same question. The coder coach I talked to said she had only seen the heart assist device used in a hospital setting. I'm thinking it is more for a LVAD (Left Ventricular Assist Device), which is a battery operated mechanical pump that in implanted to help the left ventricle pump out blood.
 
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