Health Information Management

Charge for pacemaker insertion with fluoroscopy

APCs Insider, October 8, 2004

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Charge for pacemaker insertion with fluoroscopy

Question: While in the operating room, a pacemaker insertion is done in conjunction with fluoroscopy. Can we charge for the fluoroscopy?

Answer: If properly documented, the facility can assign CPT code 71090 (insertion pacemaker, fluoroscopy and radiography, radiological supervision and interpretation) which falls into APC 0272. The unadjusted national APC payment is $77.39.  Refer to CPT Assistant August 2002, which explains that this code is intended to be used with pacemakers or cardioverterdefibrillators.  

Here is an APC tip: Medicare is proposing to require hospitals to report selected C codes for high-cost implants and devices for future data collecting. This will be the basis for APC payments. Pacemakers and cardioverterfibrillators are on the list, so please review Table 20 in the 2005 OPPS proposed rule published in the August 16, 2004, Federal Register. And remember to update your chargemaster.



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