Ask Dr. Z

Dr. Z, This help clarify the correct coding for the following 2 part question: Pt has an AICD that is nearing ERI but would benefit from an upgrade to BiV ICD as she has wide QRS complex, RBBB, shortness of breath, as well as functional Class and EF of 15-20%. History: Ischemic cardiomyopathy, CHF, VT, CAD with CABG and AICD. Procedure: Planned upgrade of a dual-chamber implantable cardioverter defibrillator to biventricular implantable cardioverter defibrillation. Pt was brought back to the cath lab. Informed consent obtained. On examination of the skin, there appears to be active cellulitis of the back and the procedure was cancelled. I coded 33249-73; is that correct? Secondly, when pt is readmitted for the upgrade to BiV would codes 33249 and 33225 be appropriate and how do we bypass the edit for the QO modifier as this is not a new preventative AICD placement? Thanks very much for your help.