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Wiki Replacement of generator and atrial lead

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Summer

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Question: when a physician replaces a generator (from a dual chamber) and capped an existing atrial lead then inserted a new atrial lead which CPT codes should we be using?

Thank you in advance.
 
Summer said:
Question: when a physician replaces a generator (from a dual chamber) and capped an existing atrial lead then inserted a new atrial lead which CPT codes should we be using?

Thank you in advance.
Click to expand...

Based on your answer of pacemaker, I would code:

33233 for removal of old pacer pulse generator
33208 for placement of new pulse generator (dual lead/atrial and ventricular), this code inlcudes the new atrial electrode placement.

This is not my primary field, perhaps others will weigh in.

HTH :)
 
Generator Change and New RA Electrode

The proper way to code the case you describe is as follows:

33233 - Removal of permanent pacemaker pulse generator only
33206 - Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial

It is a little goofy appearing at first because the patient is being sent home with a functioning dual chamber pacemaker system. However, the AMA clarified a few years back that we are supposed to use the system implant code that accurately describes the hardware that the doctor personally implanted. In your case, the doctor implanted a generator and a new atrial lead - this is the definition of code 33206. We would not want report 33208 because it would compensate us for the implantation of a generator, a right atrial lead, and a right ventricular lead - auditors would pounce on this as over coding if the report was selected for audit.

Hope this helps; Jim Collins, CPC, CCC - President CardiologyCoder.Com
 
jsccollins said:
The proper way to code the case you describe is as follows:

33233 - Removal of permanent pacemaker pulse generator only
33206 - Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial

It is a little goofy appearing at first because the patient is being sent home with a functioning dual chamber pacemaker system. However, the AMA clarified a few years back that we are supposed to use the system implant code that accurately describes the hardware that the doctor personally implanted. In your case, the doctor implanted a generator and a new atrial lead - this is the definition of code 33206. We would not want report 33208 because it would compensate us for the implantation of a generator, a right atrial lead, and a right ventricular lead - auditors would pounce on this as over coding if the report was selected for audit.

Hope this helps; Jim Collins, CPC, CCC - President CardiologyCoder.Com
Click to expand...

That makes sense, thanks for the explanation. Practically speaking it does not matter how many chambers the replacement PG has, only now many leads are placed.
 
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