Ask Dr. Z

Has there been any issues with Procedure to Device edits or Device to procedure edits that are causing coding issues? I know recently CMS identified C1882 issue with 33249 just this month which is scheduled to clear April 1st, 2012. Recently,I had a patient that returned for end of life Battery depletion. Incision is made & device pocket opened. Medtronic model D154ATG,which was a BI-VI was removed. The atril, RV shock & RV p.s leads were then tested and adequate pacing thresholds obtained. The new Biotronik Dual Chamber ICD was then attached to the leads and inserted into the pocket Model # 360346 DDDR. The subcutaneous tissue was first closed with interrupted stitching using 2-0, 3-0 Vicryl. The skin was closed with running subcuticular stitching using 4-0 Vicryl. After the procedure, the incision was secured with Derma-Bond and Steri-Strips and a sterile dressing. On leaving the Cath Lab, the leads were in proper position and patient was hemodynamically stable. A chest x ray was ordered and the patient was transported back to the Telemetry Unit in stable condition. Coded 33249 with C1721 attached to the Generator. Please advise if you have any additional information that will help us get this claim out the door. Thanks, MC