Ask Dr. Z

In a case where the patient was scheduled for an upgrade from dual PM to BiVi PM, the doctor was not able to implant the LV lead. I’m coding 33225-74 because it is specific to why patient was on the table, because additional supplies and time was used, and because the doctor states “concern for complications” and aborted the procedure. The doctor then added a new RV lead and exchanged the dual PM so I’m also coding 33207 and 33233. Do you agree with my codes? Also, if the patient is for a brand new BiVi PM and doctor cannot place the LV lead and just places the dual PM, should I be coding 33225-74 as well? I have been just coding for a dual PM insertion. I’m interested in your thoughts. Thanks!