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Thread: New codes

  1. #1
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    Default New codes

    Promo: Code Books
    Does anyone know how to bill pacer or ICD generator changes with placement of a LV lead utilizing the new 2012 codes? Neither my colleague nor I can work it out.

  2. #2
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    71090- Deleted, fluoroscopy is included in all procedures.

    New CPT Codes:

    33221- Insertion of pacemaker pulse generator only; with existing multiple leads.

    33224- Insertion of pacing electrode, cardiac venous system, for left ventricular pacing w/attachment to previous placed pacemaker or pacing cardio-defibrillator pulse generator (includes pocket revision, removal, and insertion of existing generator)

    33227- Removal of permanent pacemaker pulse generator w/ replacement of pacemaker pulse generator, single lead system

    33228- Removal of permanent pacemaker pulse generator w/ replacement of pacemaker pulse generator, dual lead system

    33229- Removal of permanent pacemaker pulse generator w/ replacement of pacemaker pulse generator, multiple lead systems.

    ### These 3 above replace the 33213, 33233. We will only bill for one code, either single or dual or multiple lead.

    33230- Insertion of pacing cardio-defibrillator pulse generator only w/ existing dual leads.

    33231- Insertion of pacing cardio-defibrillator pulse generator only, w/ existing multiple leads.


    33262- Removal of pacing cardio-defib pulse generator w/ replacement of pacing cardio-defibrillator pulse generator, single lead system

    33263- Removal of pacing cardio-defib pulse generator w/ replacement of pacing cardio-defib pulse generator, dual lead system

    33264- Removal of pacing cardio-defib pulse generator w/ replacement of pacing cardio-defib pulse generator, multiple lead system

    ### These 3 above replace the 33240, 33241. We will only bill for one code, either single, dual or multiple leads.



    Kris Felty, CPC, CCC, CCVTC

  3. #3
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    Default New codes

    Thanks for the replies but I still don't see the answer. I want to bill the new codes for generator changes (33227-33229,33262-33264) but with 33225 as well for LV lead, but they cannot be billed together. No other codes seem to work either.

  4. #4

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    According to the Cardiac Rhythm Management Coder: Code 33225 is reported when the lead placed within the coronary sinus is connected to a new pacemaker generator or ICD. This code is also reported when the existing pacemaker generator or ICD is removed and replaced or upgraded.
    That being the case, you should be able to bill both.

    Hope that helps,
    Susan

  5. #5
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    Default New codes

    Unfortunately, the verbage in CPT that goes with 33225 listing the codes it can be billed with don't include the new generator change codes. Encoder Pro also does not allow them to be billed together. That's my problem.

  6. #6
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    Quote Originally Posted by wassock View Post
    Unfortunately, the verbage in CPT that goes with 33225 listing the codes it can be billed with don't include the new generator change codes. Encoder Pro also does not allow them to be billed together. That's my problem.
    That is weird and very frustrating, I'm sure. I wonder if CPT made a mistake? When I look at NCCI, it does not show codes for 33227-33229 to be bundled with 33225. I guess it's a possibility they did not consider that scenario. I'm not on Encoder but our edit system is allowing them to be billed.
    Julie Graham, BA, CPC, CCC

  7. #7
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    Yes they can be billed together. If a LV lead is implanted at the time of a generator change(33227-33229, 33262-33264) Report the revised LV lead code 33225.
    It may be that they are not updated in their systems yet. I have gotten this info from two very reliable, credible sources.

    Kris Felty, CPC, CCC, CCVTC

  8. #8

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    Well, what about 33224?
    Just a thought!

  9. #9

    Question HELP!!! Confused on new ICD replacement code when billed with LV lead insertion 33225

    I have the same question accoring to the AMA 2012 CPT book, 33225 can not be billed with 33262-33264 which is for the ICD generator removal and replacement. so I thought that maybe I could bill for the removal 33241 and then bill 33230 for the insertion of a new ICD with existing dual leads because my docs patient had an old ICD that had leads placed in the RT venticale and RT atrium and bill 33230 with 33225 which is okay, but then in the guidelines it states that 33241 can not be billed with 33230 and to use 33262-33264 when a ICD generator is being replacemented!!! oh this is soo cofusing because the AMA book states that 33225 of course is an add on code and has to have a primary procedure, but 33227-33229 and 33262-33264 is not considered a procedures that can be billed in conjunction with 33225!! Please someone HELP!!!

  10. #10
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    Same with 33224, it can be billed as well. This you would use if attaching to previously placed generator ot defilrillator.

    Kris Felty, CPC, CCC, CCVTC

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