Wiki Pacemaker Insertion with Cardioversion

[laurap]

We have a physician who performed a dual chamber pacemaker insertion (CPT code 33208) with an intraoperative cardioversion (CPT code 92960).

There are CCI edits in place for these codes, but a modifier is allowed to overide the edits.

My question is: When is it appropriate to use the modifier and bill these codes together?

Any help would be appreciated.


Thank you,

Laura L. Porter, CPC
Jamestown Area Medical Associates

 

[MARCYL]

Yes you can post them together using a 59 mod on the cv

 

[twizzle]

We have a physician who performed a dual chamber pacemaker insertion (CPT code 33208) with an intraoperative cardioversion (CPT code 92960).

There are CCI edits in place for these codes, but a modifier is allowed to overide the edits.

My question is: When is it appropriate to use the modifier and bill these codes together?

Any help would be appreciated.


Thank you,

Laura L. Porter, CPC
Jamestown Area Medical Associates

It depends on the circumstances as to why they did a cardioversion. If the pacer implant procedure caused the patient to go into a-fib and they cardioverted the patient you cannot bill it. The same goes for EP procedures.
If the intent before the surgery was to do a pacer implant and a cardioversion, it would be appropriate to unbundle them with a 59 and bill both procedures.
No guarantee the cardioversion would pay though.

 

[Highlyfavored]

I would use the 59 modifier on the cardioversion

 

[laurap]

Thank you for your responses!

Laura L. Porter, CPC
Jamestown Area Medical Associates