Wiki Need help - on sameday ICD lead revision

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vidraj

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Buffalo Grove, IL
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Hello everyone,

I need help with the following procedure.

Procedure Summary:
Successful implant of CRT - D Medtronic
Successful LV lead revision.Removal of S shaped lead and placement of new L shaped lead

In short, patient had inital ICD gen, New RA , RV and LV implant.
After removing the drapes, device check revealed that LV was not capturing .So, patient was prepped again, and S shaped lead was extracted and new L shaped lead was implanted.
Patient left the room with New ICD gen , New RA lead, New RV lead and New L shaped lead.

Should I code 33249 and 33225 only
or additionally , How do I code this lead revision on the same day ?

TIA
 
Since the patient did not leave the table, i would not code extra. I would look at possibly added a 22 modifier for the extra work.

If the patient had left OR; returned to his room; then had new problems/symptoms; returned to the OR; then malfunctioning or dislodged (or whatever) LV lead removed and a new one implanted; only then I would consider 33244 and 33224.
 
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