Question Post-Op External Pacing

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Good Morning!

Is there a cpt code for post-op *external* pacing of a 3rd degree heart block?

Background: The patient is 16 day s/p TGA Transposition and VSD repair w a resultant 3rd degree heart block. Atrial and Ventricular pacing wires were placed during the procedure and the patient's condition is now managed by providers in the PICU. My CC providers are billing 92953 which bundles w all CC codes and isn't correct anyways (pacing wires aren't transcutaneous).

I've searched for the answer using a kazillion different search terms and am coming up w nothing. I feel like the answer is soooo obvious and I'm just not seeing it. :-\

Andrea Tomerlin Williams
HIM ProFee Coder II
Children's Hospital of San Antonio
 

kathrynw

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Hi,
Wow this was a tough one. I too feel like it should be easy; just like a ventilator CPT (i.e. 94002) after intubation, shouldn't there be a code for the programming and monitoring of the temporary pacing? The only thing I can see is a PCS code in the 5A1 range. 92953 doesn't seem correct because if they need to actually pace the patient the device would have to be attached to the wires that are sticking up through the skin, not through pads. Another possible conclusion is that this is inclusive in the CPT code for the actual surgery. It might not be a bad idea to try contacting the device manufacturer of the temporary postoperative epicardial pacers that you use to see what they recommend billing.
Hopefully this helps,
 
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