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Lead Revision after AICD Placement

  1. Default Lead Revision after AICD Placement
    Medical Coding Books
    Is this covered in the global surgical package or not? Here is the scenario:

    A patient has an elective Dual Chamber AICD implant on 12/16/11, stays in 23 hour obs and is discharged the next day with no complications.

    On 12/18/11 patient presents to the ED stating that she "felt funny like my body was twitching from the pacemaker". Her device was interrogated and there was right atrial lead dislodgment. She was admitted to the hospital as an inpatient. On 12/19/11, the physician who did the original AICD implant did an H&P on the patient and decided to do a lead revision that same day.

    Lead revision was done 12/19/11 with no complications and the patient was discharged home on 12/20/11.

    My question is, is any or all of this covered under the global surgical package from the AICD implant or is it seperately billable and payable using modifiers?


  2. #2
    upper saddle river,nj
    Red face
    You can use modifier -78 (unplanned return to the OR during the post-op period) due to the fact that the patient was having mechanical issues with the device. I would use diagnosis code 996.04 for the lead revision procedure. Let me know if this helps you any.

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