Here is your ZHealth Coding Newsletter
for February 2007
Below
is a recent coding question submitted by one of our
ZHealth Online members – and
Dr. Z’s
answer:
Coding
Question: The procedure report
indicates that an existing cardioverter-defibrillator
generator was removed from the patient. The
malfunctioning lead was then attempted to be repaired
without success, necessitating insertion of a new lead.
The MD documents "using seldinger technique the J
guidewire was advanced without difficulty. An 8 Fr
sheath and dilator system was advanced over this and
through this a St. Jude Riata model #1580 was advanced
to the inferior vena cava. A curved stylet was used to
maneuver the lead to the right ventricular apical region
where it was actively fixated." Subsequently the
existing cardioverter-defibrillator was reimplanted into
the patient and reconnected to the leads. I am
recommending that the lead placement be reported with
33216 and the explant and reimplant of the generator be
reported with the unlisted code 33999. I feel that since
the generator implant codes include payment for device
that it would not be appropriate to report generator
placement code. Are my codes accurate or do you have
other suggestions?
Dr. Z’s
Answer:
The placement of a new lead includes the removal and
replacement of the same generator from and back into the
pocket if needed. I would only code for the new lead
placement. The descriptors of the newer Left ventricular
lead placement to existing system actually incorporate
this verbiage into the CPT code.
Hopefully, they will add the same verbiage to the
other lead replacement codes soon. Don't forget to
charge for the initial lead removal if documented. Do
not code lead removal if the lead is merely
capped.
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Shipping Status
Each one of
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involved in the complex world of coding interventional
radiology, vascular, endovascular, and cardiology
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Order
your coding references today. We apologize any
inconvenience caused by by the delay in
shipping the new publications. Please see
the current shipping status per
book, below:
Dr. Z’s Medical Coding
Series: Vascular & Endovascular Coding
Reference: 2007
Edition – Now
Shipping. See the Table of Contents. Also view an excerpt of the new
book.
Dr. Z’s Medical Coding
Series: Interventional Radiology Coding
Reference: 2007
Edition
– Shipping date: February 27, 2007. See the Table of Contents.
Dr. Z’s Medical Coding
Series: Interventional Cardiology Coding
Reference: 2007
Edition
– Shipping date: early April 2007 (not
pictured at right).
Let us know if you have any
questions about the new books.
2007
ZHealth Coding Seminars
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you could not join us this week in Phoenix, we hope
that you can make it to another ZHealth Coding
Seminar in 2007. Here’s
our remaining schedule for the
year:
Sign up today for a 2007 ZHealth
Coding Seminar and receive a free a copy
($295 value) of the new 2007 Dr. Z's Interventional
Radiology Coding Reference.
