I read your report and the codes you are using are not correct. Billing with 33240 & 33225,33216 is the problem. Using these 3 codes you are actually unbundling 33249.
The correct codes to use as documented in your report are:
33241- removal of a single/dual chamber pacing ICD generator
33249 - Insertion or repositioning of electrode lead(s) for a single or dual chamber ICD and insertion of pulse generator
71090-26 - insertion of pacemaker/ICD fluoroscopy
93641-26 - testing of single or dual chamber pacing ICD generator
When coding for a replacement of generator or leads or upgrading from a single to dual chamber pacemaker or ICD you only bill what you put in. Since a new generator and 1 lead was implanted 33249 is the correct code to use.
71090-26 "under fluoroscopy" was stated. Since the MD mentioned he used fluorscopy during this procedure you can bill for this. All pacemaker and ICD reports must indicate use of fluoroscopy in order to bill for it.
93641-26- MD tested the generator and you can also bill for this. Report should indicate testing was done in order to bill. 93614-26 is for testing of the generator during the procedure.
I have a question above the device codes you use. Our EP has never used the C codes. I have never heard of billing C codes. why or how are they used?
I hope this information has been helpful and I appreciate your feedback about the C codes.
have a great day,
Dolores, CPC, CCC
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