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Thread: ICD generator change with lead eval

  1. #1
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    Default ICD generator change with lead eval

    In the CPT book it says Fluroscopy can't be used with codes 33206-33249 but to report fluorscopic guidance for diagnostic lead evulation w/o lead insertion, replacement or revision prodecures use 76000.

    I have a procedure where the MD did a ICD generator change (33263) and then under fluorscopy check the leads for position. This sounds like it falls under the guidelines to bill 76000. I'm I correct?

  2. #2
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    Quote Originally Posted by Robbin109 View Post
    In the CPT book it says Fluroscopy can't be used with codes 33206-33249 but to report fluorscopic guidance for diagnostic lead evulation w/o lead insertion, replacement or revision prodecures use 76000.

    I have a procedure where the MD did a ICD generator change (33263) and then under fluorscopy check the leads for position. This sounds like it falls under the guidelines to bill 76000. I'm I correct?
    According to the guidelines the 76000 is only reportable for diagnostic lead evaluation without insertion, replacment or revision procedures/ Since your physician is checking position of the lead after placing I would say this is not a diagnostic evaluation and should not be billed.

    Just my opinion....
    Terri Winsor, CPC, CCC

  3. #3
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    I would bill it with the 76000 because the physician only did a generator change. As long as he did nothing to the leads you should be fine to bill flouroscopy.
    Leah, CCC

  4. #4
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    Checking lead position after placement is not the same as evaluating a lead.
    Terri Winsor, CPC, CCC

  5. #5
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    What would consider "evaluation of a lead"?

    The CPT books says " Radiological supervision and interpretation related to the pacemaker or pacing cardioverter-defibrillator procedure is included in 33206-33249. To report fluoroscopic guidance for diagnostic lead evaluation without lead insertion, replacement, or relacement or revision procedures, use 76000"

    ....so it's not ANY insertion/replace/revision procudures, but LEAD insert/replace/revision procedures.

    He is basically checking the positions of the leads after changing the battery which he needs fluroscopy to do. Code 33263 isn't included in the range 33206-33249 mentioned above.

    Thoughts?

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