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ICD and pacemaker
Date: Mar 12, 2012
Question:
Dr. Z,
I attended the course in Nashville as well as the one in Vegas the year before. We are having issues with the CPT code 33224 LV lead placement. In the past, we have charged for the generator removal (pacemaker usually) 33233, place the LV lead and put in the new ICD (usually) generator. So, we would have had 33233, 33224 and 33249 (because they would put in an ICD lead also), as well as fluoro. We didn’t realize that 33224 last year included the removal and replacement of the generator, which was always a new generator because the old generator couldn’t hold all three leads. My problem is that we were charging for the old generator to be removed and a new one placed and didn’t realize it was included in the code 33224. So our cost was much more than what it should have been, we are now realizing. One thing that might have kept us not getting any edits or have any other type of issue, is that the coders probably didn’t code that for payment(generator removal.) Our finance department can’t understand why the cost for an ICD placement is higher than a pacemaker placement. We are trying to stay budget neutral until this budget year is over. Ours runs from June 1 to May 31. Is it normal for the ICD implant cost to be higher? I don’t have anything to do with setting cost, but need to try and help make this correct from here on out. Again, we didn’t have any issues with the bills or payments, so I feel that the coders were correcting the bill before it dropped for billing. Any insight would be very much appreciated. Hope to attend the Nashville seminar again this year. Thanks,
I attended the course in Nashville as well as the one in Vegas the year before. We are having issues with the CPT code 33224 LV lead placement. In the past, we have charged for the generator removal (pacemaker usually) 33233, place the LV lead and put in the new ICD (usually) generator. So, we would have had 33233, 33224 and 33249 (because they would put in an ICD lead also), as well as fluoro. We didn’t realize that 33224 last year included the removal and replacement of the generator, which was always a new generator because the old generator couldn’t hold all three leads. My problem is that we were charging for the old generator to be removed and a new one placed and didn’t realize it was included in the code 33224. So our cost was much more than what it should have been, we are now realizing. One thing that might have kept us not getting any edits or have any other type of issue, is that the coders probably didn’t code that for payment(generator removal.) Our finance department can’t understand why the cost for an ICD placement is higher than a pacemaker placement. We are trying to stay budget neutral until this budget year is over. Ours runs from June 1 to May 31. Is it normal for the ICD implant cost to be higher? I don’t have anything to do with setting cost, but need to try and help make this correct from here on out. Again, we didn’t have any issues with the bills or payments, so I feel that the coders were correcting the bill before it dropped for billing. Any insight would be very much appreciated. Hope to attend the Nashville seminar again this year. Thanks,
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