Ask Dr. Z

One of our surgeons is wanting to bill a venogram only (75820) for an attempted pacemaker insertion. To summarize the note, he makes the incision between the clavicular angle and the delta-pectoral groove, does not see the cephalic vein, does a venogram of the subclavian vein, makes a few attempts at access, and is unsuccessful. The patient has COPD and HR was over 110, so the procedure was stopped and wound was closed. Could we still do the PM implant with modifier -53? I'm hesitant to bill this since it didn't seem like very much was done here. Also, if we can bill for the PM placement with modifier -53, should I just do the 33207 since the provider doesn't indicate whether he planned to place a single or dual chamber device?