Multilead vs. Dual Chamber correct coding for BiV devices w/o Atrial Leads
Your reference book defines “multi-lead device” for PPM/ICD implant/revisions as biventricular, and states a multi-lead device does not need an atrial lead (pg. 546/560). CPT clearly defines "multi-lead" as leads in three heart chambers. CPT Assistant, 12/2013, clarified: “When a LV lead is implanted, the system is referred to as a multiple lead system.” But CPT further clarified their guidelines in 2015 and continues to reiterate their definition of multi-lead for 33206-33249, 33264 as a device “with pacing/sensing function in 3 or more chambers of the heart”. Please clarify if/when it is appropriate to report multi-lead codes (33229, 33264, 33221, 33231, and 93281, 93284) for devices that only have RV/LV leads? Is it correct that we code dual chamber biventricular devices as “multi-lead” when it comes to device revision codes, but they are considered “dual chamber” for programming evaluation codes? So we could conceivably report 33229 for a multi-lead PPM generator change in a patient with LV/RV lead, but would subsequently report 99280 for dual chamber programming evaluation on the exact same system?
Need to ask Dr.Z?Don't see the answer you're looking for in the knowledge base? No problem. You can ask Dr. Z directly!
Ask Dr. Z a question now!