Q & A with Dr. David Zielske
Question: Permatemp Pacemaker Placed Post TAVR
Recently our cardiologists have started prophylactically inserting a "permatemp pacemaker" at the end of all TAVR procedures as part of a new guideline (I'm not sure whether this is an internal policy or a new guideline for standard of care on all TAVR procedures). If no significant heart block develops, they are removed later.
I feel that we should not bill for prophylactic care and that codes 33216 and 33234 should only be billed when the patient is documented as having heart block necessitating the continued pacing after removal of the pacing wire/balloon used during the TAVR. What are your thoughts?