Health Information Management

Tip of the Week: New pacemaker CPT codes do not include pulse generator insertion

APCs Insider, April 20, 2007

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Shannon McCall, RHIA, CCS, CPC, director of HIM/coding for HCPro, Inc., in Marblehead, MA, suggests the following tips when coding pacemakers:

  • Distinguish between a single- and dual-chamber system. A single system is one in which the physician places a pulse generator and one electrode in either the right atrium or right ventricle. A dual-chamber system is one in which the physician places a pulse generator in the right atrium and one electrode in the right ventricle. To view an example of a single pacemaker system that MedlinePlus provides, visit http://www.nlm.nih.gov/medlineplus/ency/imagepages/19566.htm.
  • Recognize that biventricular pacing is not synonymous with a dual-chamber system. Biventricular pacing occurs when a physician places an additional electrode in the left ventricle. Note that CPT inserted additional guidelines for 2007 to distinguish among biventricular pacing, single system, and dual-chamber system. To view a diagram of the heart that shows each atrium and ventricle of the heart, visit MedlinePlus' Web site at http://www.nlm.nih.gov/medlineplus/ency/imagepages/19612.htm

Consider the following two examples of biventricular pacing:

A patient with congestive heart failure presents with a previously placed single-chamber pacemaker system in the right ventricle that a physician inserted one year ago. The patient presents today for placement of a left ventricular electrode/lead to achieve biventricular pacing. Report code 33224 for this scenario.

A patient with congestive heart failure presents for an initial insertion of a single-chamber ventricular system (right ventricle) with a transvenous electrode. During the same session, the patient also undergoes a left ventricular electrode/lead placement. Report codes 33207 and 33225 for this scenario.

(Source: JustCoding.com, April 2007).



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