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C1900 Lead for LV Pacing in Bundle of HIS

Date: Jan 9, 2023


Patient presents for cardiac resynchronization therapy due to severe LV dysfunction with EP 15-20% , chronic ischemic cardiomyopathy and left bundle branch block. A Medtronicquadripolar lead (C1900) was delivered into the proximal posterior lateral vein through the coronary sinus guide sheath, however given the small caliber of the vessel the lead could not be extended sufficiently into the branch. Multiple attempts were made but due to the unsuitable coronary sinus anatomy this attempt had to be abandoned. Lead was advanced to the region of the HIS bundle until adequate sensing and thresholds were confirmed. ICD was attached to leads.

Since the physician used C1900 lead in bundle of HIS to obtain LV pacing can we charge 33249 and 33225?

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