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Pacemaker or Cardioverter defibrillator?

  1. Default Pacemaker or Cardioverter defibrillator?
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    Im confused. Can someone explain. On a practice exam, Procedure: Dual chamber pacemaker defibrillator implantation. The codes with pacemaker did not state "defibrillator", but I thought pacemaker and defibrillator were different, matter fact cardioverter is listed with defibrillator. If any one can explain, I would appreciate it. I think the problem is poorly worded

  2. #2
    Sarasota FL
    Default Pacemaker/defibrillator
    Yes it is poorly worded but both devices regulate (pace) the heart. A pacemaker will speed up the heart and a defib will effectively slow it down when it needs to. I think that for the purposes of this question, the word defibrillator indicates just that....defib device. I guess the powers that be were just trying to confuse you, but at the same time make you think. That is what the CPC is all about.

  3. Default Pacemaker or Defibrillator? hardest dilema was trying to figure out why both words were being used. So if it states defibrillator, dont worry about the pacemaker wording???

    My next dilema is the difference in 33240 and 33249. Is 33240 just the insertion of the generator?

    The codes to chose from for this procedure are:
    a) 33207
    B) 33208, 71090-26
    C) 33240, 33208, 71090
    D) 33249, 71090-26

    I picked B because it had pacemaker, electrodes to both arium and ventricle (but no defibrillator or dual in the wording)

    I thought 33240 was a good choice I thought, but it is paired with 33208 in the answer for C, (didnt think it could be both)


  4. Default electrode leads
    Also, 233208 says electrodes and code 33249 state electrode leads or just leads. are they all the same? If it states electrode can i take it to mean leads?

  5. #5
    Sarasota FL
    Default Defibrillator
    D is really the only answer that can be correct. 33240 would be a defib generator only, and you could not bill it with a pacemaker (dual) system which 33208 describes. 33207 describes a single chamber (ventricular lead only ) pacemaker system. 33249 is a debrillator system ... generator and lead(s) with 71090-26 being the fluoroscopy for placement of the leads ( electrodes). 33208 would work if they did not mention the word "defibrillator". That applies to a dual chamber pacemaker system.
    I hope this helps. It really is confusing at first but having billed these kind of procedures for nearly two years, it becomes quite easy once you know the difference between a pacer and a defibrillator. It's worth reading the intro to the section on defibs and pacers in CPT.

  6. Default Pacemaker or Defibrillator?
    Thank you so much for your help!

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