Wiki MD transects ICD lead

[Margaret Morgan]

Good morning,

I have a BiV ICD generator removal and replacement case and during the surgery the physician transects the existing LV lead. He ends up replacing the LV lead and capping the transected lead. Can I bill for the new lead? or only 33264? I am double guessing myself.

thank you in advance,
Margaret

 

[Jim Pawloski]

Bill for a new ICD generator, 33249.

HTH,
Jim

 

[twizzle]

Some time since I coded EP but wouldn't you bill 33264 and 33225 Jim?

 

[Jim Pawloski]

It's been a while for me too. After researching this, I missed that it was a LV lead, so I think 33225 for the LV lead insertion, and 33263 for exchange of a dual lead system since the LV lead was accidently cut.

 

[twizzle]

BiV ICD generator change would be 33264 though - not a dual generator change. Maybe someone else could comment.
33264, 33225 I think.

 

[cgaston]

Did they accidentally transect the lead? If so, this would be a case of "you break it, you bought it" and would not be billable. The physician shouldn't get paid to fix his or her mistake.

 

[Margaret Morgan]

Yes, it was accidentally cut. Cut lead was not repaired or removed but capped. Then a new LV lead was placed and biv generator was removed and new one implanted. I was thinking just the 33264 and nothing else but wanted a second opinion.