upgrade from single chamber ICD to dual chamber ICD

denisek1028

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Just need to confirm that I am correct. My provider removed a single chamber ICD and inserted a dual chamber ICD and also a new lead. Would we use the combined removal and replace code of 33263? Would we also bill for the addition of the new lead?

Thank you!

Denise
 

Casper204

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Somers, CT
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I work for an EP group and see this kind of case a lot. You can't code 33263 with 33216. Because he added a lead it would be coded 33249 and 33241-51. 33249 covers the insertion of the new generator and the addition of the lead and 33241 covers the removal.

Cristine Ward, CPC
 

twizzle

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I work for an EP group and see this kind of case a lot. You can't code 33263 with 33216. Because he added a lead it would be coded 33249 and 33241-51. 33249 covers the insertion of the new generator and the addition of the lead and 33241 covers the removal.

Cristine Ward, CPC

Yes, I agree with Casper204. The generator change codes are really only used when no lead placement is performed. As soon as you add a (right) lead it becomes a complete system. An exception would be if a generator was replaced and an LV lead was added then you would use the appropriate generator change code and 33225.
 

CodingKing

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I'd like to add a second, I concur with Casper204 and why

There is really a handy 3 column table in the CPT book. Once of the option is conversion from single chamber to dial chamber. The 2 columns describe the codes for a Pacemaker or ICD. Under ICD column it says 33249 + 33241.

I really love the charts in the CPT book, It makes these types of situations so much easier.
 
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Chennai
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Yes, I agree with Casper204. The generator change codes are really only used when no lead placement is performed. As soon as you add a (right) lead it becomes a complete system. An exception would be if a generator was replaced and an LV lead was added then you would use the appropriate generator change code and 33225.

This is for a changing a system to biventricular system, not just for a normal upgrading of single chamber to dual chamber. For a normal upgrading use 33241+33249 - Upgrade single chamber system to dual chamber system
 
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