Ask Dr. Z

A documented pacemaker dependent patient was brought in for end-of-life pacemaker generator replacement. A temporary pacemaker single chamber was inserted, and the dual pacemaker was replaced. The patient was placed in observation where it was noticed that there was a sudden loss of ventricular capture due to the chronic ventricular lead being displaced. The patient was taken to the special radiology suite emergently and had a temporary pacemaker wire placed and then was taken to the cardiology suite where the chronic ventricular lead was replaced. This was originally billed as two sessions (33228 with 33210-59, and 33234 with 33216 and 33210-59). Code 33228 is not allowed with 33216 even with an appropriate modifier. Can we bill codes 33207, 33234, and 33210-59 x 2?