Search results

  1. C

    Wiki ICD 10 code for ILR no longer needed... NOT ERI

    What would a proper ICD10 code be, if the patient received an ILR x 2years with no syncope and wanted it out? thanks in advance would Z45.010 or Z45.018 work in this instance if it was an ILR that was placed for syncope and after 2 years had zero episodes and patient wanted it removed? OR is...
  2. C

    Wiki 58 planned return

    if a patient has a temp pacemaker and returns for the actual implant of a pacemaker, do it get a '58' planned return ? (3 days) thank you
  3. C

    Wiki modifier

    if a patient had a TAVR, required a temp pacing wire 33210 (May 7), received a dual chamber pacemaker (May 8), does it need a modifier (global period)?
  4. C

    Wiki AV Node ablation 93650

    IS i48.19 an acceptable ICD10 code for a AV node ablation (PPM implanted just prior to the node ablation, or do i need another ICD10 code? thanks in advance
  5. C

    Wiki upgrade to CRT/P.. no CS lead

    Buddy came in and received a new RV lead and a CRT/P can The old RV lead was plugged into the LV port and the RA lead was ok and reused. would this be coded as a mere 33207? (and 33233 for the pacemaker can explant)
  6. C

    Wiki ICD10 code

    thank you !!!
  7. C

    Wiki pericardiocentesis

    thanks Jim. They definitely used fluoroscopy but they also used ICE as the effusion was large and difficult
  8. C

    Wiki pericardiocentesis

    although i am not getting a 'do not code together' error, or in CPT, but can 93662 be billed with 33016? OR is it assumed that ICE is necessary to perform? thanks in advance
  9. C

    Wiki ICD10 code

    if a patient received a pacemaker implant last year because of AV block (lyme disease) and totally recovered, wishing the pacemaker removed. What would a proper ICD10 code be, if there is nothing wrong with the device or leads. thanks in advance
  10. C

    Wiki CTI then DCCV

    pt came in for a flutter line, who went into fib after the line was complete. He did not want to go transeptal, so they cardioverted him at the end. can the 92960/59 be billed with the 93653 in this situation? as it was not part of the case itself, as in, they didn't cardiovert in the middle...
  11. C

    Wiki how many modifiers?

    thank you so so much :)
  12. C

    Wiki how many modifiers?

    if a patient comes in within 2 days for an ICD lead explant, ICD re implant, and a repositioning of another lead... do all three received the 'unplanned return' 78, or just the one with the highest RVU thanks in advance
  13. C

    Wiki EM ICD vs Subcutaneous ICD

    thank you :)(y)
  14. C

    Wiki WATCHMAN EXPLANT

    we are preparing to do a watchman explant in the coming weeks (in EP). i checked a 'structural heart' bill where they performed the procedure 2 years ago as follows: Upon discussing this case, we felt that coding these together is not quite right, as in billing for it twice. Like the 33370 alone...
  15. C

    Wiki EM ICD vs Subcutaneous ICD

    Can anyone tell me if their organization codes the new EV ICD with the temporary code 0571T or is the 33270 being billed. We 'attempted' our first this am: 0571T = insertion or replacement of implantable cardioverter defibrillator system w/substernal electrode(s) including all imaging guidance...
  16. C

    Wiki CMS

    what is the best way to navigate through the CMS website... specifically for the requirements for a CRT-PACEMAKER implant - ICD10 codes to support medical necessity thanks in adance Chris
  17. C

    Wiki can this be '2' 93657?

    Re-do PVI, PWI for atrial fibrillation: We performed ablation with an anterior hemi-WACA on the left side (along coumadin ridge) to reisolate the LPVs using an irrigated-tip ablation catheter (Biosense Thermocool SmartTouch STSF D curve). First pass isolation was achieved with bidirectional...
  18. C

    Wiki does this need a modifier 59

    thanks, again, Jim for your expertise. Chris
  19. C

    Wiki does this need a modifier 59

    pt had a CTI 93653 with a PPM 33208. does one of the codes need a '59' modifier? thanks in advance
  20. C

    Wiki modifier 58

    if buddy had a temp pacer placed on a Friday and came back (planned/staged) for a pacemaker implant, does the pacemaker implant get a '58' thanks in advance
  21. C

    Paige i was just looking at your exam results. I'm scheduled to write end of year, and the E/...

    Paige i was just looking at your exam results. I'm scheduled to write end of year, and the E/ M baffles me. is there any helpful tips you can throw my way to help me understand it? thanks in advance chris
  22. C

    Wiki how can this be billed?

    The intent was VT ablation, Due to the inability to induce, despite stim/burst pacing and giving prel, the case was concluded. can i modify the 93654 with a 52 or 53 , (in addition bill 93662, 93623) OR can this be billed 93620 93623 (with ICE not billable)? thanks in advance. Intra-cardiac...
  23. C

    Wiki PVI +/- additional work for fib +/- Vein of Marshall

    We have a few new attendings who are learning the complex world of billing. Scenario #1: Everything for a PVI is done, checking all veins for block, NOT ablation of veins. Extra lines, cafe, box lesion set ... performed for afib Can the 93656 be billed to encompass everything? OR do the...
  24. C

    Wiki is this ICD10 code enough?

    Patient comes in with uncontrolled Afib (for a year, and is on meds to no avail)... gets a PPM (RV lead only - 33207), for planned AVJ in the near future. IS is correct to code this with i48.20 ?
  25. C

    Wiki upgrade to CRT/P

    thanks Jim the original RV lead was put into the LV port. it was still functional but impedances were elevated; now being used as 'backup for the new RV' and 33207 is ok, even though it was a dual chamber can upgrade to a CRT can? but yes i see the new lead and can as a 33207. I was perplexed...
  26. C

    Wiki upgrade to CRT/P

    patient comes in with a dual chamber PPM. she gets generator change, with the insertion of a CRT/P can 33229? she also gets a new RV lead. the RA is fine and reused the original RV is put into the LV port the new RV is put in the RV port would i bill this new lead as an unlisted lead? as the...
  27. C

    Wiki isuprel

    this is an ongoing issue with the docs... IF isuprel is given after ablation, they try to re-induce on isuprel and pacing, but are unable to re-induce. this is not billable, correct? thanks in advance
  28. C

    Wiki 93620 or ??

    thank you makes sense now..
  29. C

    Wiki IV drug infusions

    oh my gosh... both are wrong i meant 96365 IV drug infusion (pg 827-830 CPT) but upon further investigation, it is not reportable by MD in facility setting, nor can 93623 be billed with it either.. they say you learn something new every day !! thanks chris.
  30. C

    Wiki IV drug infusions

    it is my understanding that MDs are not allowed to bill for administering specific drugs i/e procainamide / isuprel IF a drug is used to induce an arrythmia, how can it be billed. I used 93635, along with the 93623 and was told it can't be billed. thanks in advance
  31. C

    Wiki 93620 or ??

    pt comes in for comp EP eval (93620) BUT only performed the following: Vascular sites were accessed using the percutaneous modified Seldinger technique under ultrasound guidance. Access was obtained via right femoral vein with a 7F sheath . Catheters were advanced fluoroscopic guidance. A...
  32. C

    Wiki downgrade CRT/D to CRT/P

    might someone help with this . What is the CPT code for a downgrade from a CRT/D to a CRT/P I'm thinking 33221 and 33241 thanks in advance
  33. C

    Wiki 3rd lead explanted

    a CRT/D has been explanted, billing 33241 and 33244 is there any way to capture the 3rd LV lead? thanks in advance
  34. C

    Wiki isuprel

    If the doctor ablates for AVNRT... initiates prel post ablation (after waiting 30 minutes); tries to induce again by pacing(nothing inducible), is this billable? OR is this considered 'checking work'? which isn't billable thanks in advance
  35. C

    Wiki adding a modifier

    comprehensive EPS (93620) as well as implanting a implantable loop recorder (ILR) (33285) does the 33285 need a modifier 59 on it ? thanks
  36. C

    Wiki LV vs LBB lead

    if the attending's intent is to place a CRT/D, but no suitable LV targets, decides to place a LBB lead, billing as 33249 and 33999, could he bill 33225/53? and if so, would there be any sort of payment for it, if it's modified with a '53' because they aborted that plan? thanks in advance chris
  37. C

    Wiki cardiac sarcoid

    is cardiac sarcoid a stand alone code for a sub Q ICD implant? D86.85 LVEF normal thanks in advance
  38. C

    Wiki ATP

    This person came in for a cardioversion. They pace-terminated through his device instead of externally shocking, as outlined below. input on how this can be billed is greatly appreciated. We attempted to pace-terminate using decremental cycle lengths, and successfully pace-terminated atrial...
  39. C

    Wiki epicardial access

    is there a code that can be used for epicardial access? buddy in lab for VT ablation (93654); going transeptal and using ICE they then decide to go epicardially; and use needle to access pericardial space to ablate the VT he's not tapping per se (although he has removed 7mL with the...
  40. C

    Wiki interrogate and reprogram a PPM

    thank you so much Amanda I have a few beauties that one of our cardiologists gave me (I'm in EP, but close knit family :) I'm doing some review today, then scheduling it!!!!
  41. C

    Wiki is it a 33221?

    buddy goes to OR the OR team place 3 epicardial leads (not coding this) EP doc comes in, attaches a CRT/P device t the 3 epicardial leads and closes the pocket - --coding this-- EP doc goes to other side, opens and removes the old pacemaker and 2 leads --coding this-- would i do a 33229...
  42. C

    Wiki interrogate and reprogram a PPM

    thanks Amanda i see that you have a lil 'CCC; beside the rest of your initials.... how long have you had that designation? I'm prepping for the 'online' exam, and keep putting it off... how was it? thanks for any insight you can share chris.
  43. C

    Wiki interrogate and reprogram a PPM

    if buddy came in for a cardioversion, but was in sinus rhythm so no DCCV, BUT the cardiologist interrogated and reprogrammed his permanent pacemaker How would this be coded? thanks in advance chris.
  44. C

    Wiki transeptal

    as always, Thanks Jim
  45. C

    Wiki transeptal

    can you bill for transeptal for retrograde aortic ? The decanav catheter was advanced into the CS. The SL1 sheath was advanced into the CS for stability and allow for further reach. With the decanav advanced into the GCV/AIV junction, activation mapping of the PVCs showed earliest activation...
  46. C

    Wiki external / internal cardioversions

    how would you code a cardioversion that is done through a device? (chest NOT open) would it be 92961, or is that more if the chest is open during surgery? thanks in advance
  47. C

    Wiki attempted CS lead

    how do i code a RV PPM upgrade to a BIV (just the addition of a CS lead,... no RA lead being added); that was aborted due to anatomy? the 33225 is an add on, so i can't just bill that and modify as aborted. thanks in advance
  48. C

    Wiki Cardio Neuro Ablations

    is anyone billing for Cardio Neuro ablations? if so: what code is being used? is it being paid? thanks in advance
  49. C

    Wiki Pacemaker gen change; temp pacer

    thanks Jim I knew it was, but thought because it was conducive to life it may be somehow captured.
  50. C

    Wiki Pacemaker gen change; temp pacer

    there isn't much to the note. Buddy came in for a gen change... he had no underlying rhythm.. they threw in a temp pacing lead for the procedure.... switched out the device... temp lead removed. i didn't think it was billable, but thought i'd throw it out there to see if because it was conducive...
Top