Ask Dr. Z

We are aware of the exceptions to the auxiliary procedure PCS coding rule and understand that a temporary pacemaker would be coded if required to be continued beyond the operative episode. What is not understood is regarding the leads for said temporary pacemaker – under what circumstances are codes assigned for temporary pacemaker lead insertions? Here is the advice we have found to be applicable: • Coding Clinic, May - June 1987 Page: 3 - Temporary cardiac pacing indicates that the insertion and removal of the leads is included in the code for the temporary pacemaker – “Code 37.78 includes both the insertion and subsequent removal of the temporary leads (electrodes).” • CHB, Chapter 28 under Cardiac Pacemaker Therapy: “Another type of temporary pacemaker is used intraoperatively or immediately following surgery, with the leads inserted into the myocardium in an already-opened chest. Temporary pacemaker procedures are classified to 5A1213Z (intermittent) or 5A1223Z (continuous), plus the appropriate code for the lead insertion.“