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removal of left ventricle lead

  1. #1
    Default removal of left ventricle lead
    Medical Coding Books
    our physician removed a biv icd device and all three lead, in looking for the code for the removal of the LV lead I saw where Boston Scientific had recommened to use 33999 the cardiac surgery unlisted code.
    I was wondering if anyone else has encounted this issue and would I be correct in using procedure code 33999
    Thank you for your help

  2. #2
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    Was it just the removal or were new leads placed?

  3. #3
    Default Removal of left ventricle lead
    It's the removal of the whole system and a new DC ICD was implanted 2 days later.

  4. #4
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    I also am interested in this, my doctor removed IDC generator and 3 leads and
    did not replace. Does 33244 cover all three lead removals?

  5. #5
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    Report 33241 for removal of the ICD pulse generator and 33244 for the removal of the electrodes. By description, code 33244 is used to report removal of ICD "electrode(s)" - in this case, all three. While there is extra work involved in the placement of a biventricular lead [codes 33224 and 33225], there is no extra work in removal. A biventricular lead is removed in the same manner as other transvenous leads - it is disconnected from the generator, dissected from the scar tissue, twisted counter clockwise and withdrawn.

    Terry

  6. #6
    Default
    After discussions with my fellow coders and some additional research, I want to amend my previous response.

    Technically [actually], a bi-ventricular ICD is a three chambered device. Since the description for code 33244 states "Removal of single or dual chamber pacing cardioverter-defibrillator electrode(s)", it would be appropriate to report code 33999 in addition to 33244.

    There may be new codes in 2009 that deal with bi-ventricular device issues: LV lead extraction and device checks/reprogamming.

    Always learning,

    Terry

  7. Default
    Quote Originally Posted by dms View Post
    our physician removed a biv icd device and all three lead, in looking for the code for the removal of the LV lead I saw where Boston Scientific had recommened to use 33999 the cardiac surgery unlisted code.
    I was wondering if anyone else has encounted this issue and would I be correct in using procedure code 33999
    Thank you for your help
    Hi Terry,
    I just read the answer to this question on "The Cardiology Coalition" website, here is the website address:

    http://www.cardiologycoalition.com/

    The answer is the same as what you found but I think you'll find they expand on it too. It was a great find for cardiology info and after reading their January 2008 Volume 4, Issue 1 you can do a test and receive 2.5 AAPC CEU's.

    Karen Wortmann, CPC

  8. #8
    Smile
    Hi Terry & Karen

    Thank you both so much for your help, really appreciated it.

    Donna

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