Wiki ICD Implant (33249) and Q0 Modifier use

[carelitz]

I am trying to learn and understand the use of the Q0 modifier with ICD implant when billed to Medicare. From what I understand so far, the use of this modifier is to indicate to Medicare that the patient has the potential for sudden cardiac death. So that when certain Dx are used we need to append the Q0 (ie for a Dx of Sick Sinus Syndrome I49.5). If the patient has a history of SCD and V-tach we DO NOT need to use the Q0 modifier.

Adding the modifier submits their device to a registry and documents meeting the coverage requirement for devices implanted for primary prevention of sudden cardiac arrest.

Am I on the right track here?


Thanks for any information/insight.

 

[ccollison]

Modifier Q0 is used to indicate the ICD was placed for PRIMARY prevention of sudden cardiac death (prior MI, ejection fraction less than 35%, family history of v tach or cardiomyopathy. Q0 is not needed if the ICD is implanted for SECONDARY prevention of cardiac arrest.

C. Collison CPPM, CPC, CCC, CPMA

 

[cgbar]

Q0 is a Medicare only.....not for Medicaid or private payers. SSS is for Pacemakers btw (the KX modifier required).

 

[carelitz]

Thanks!