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Pacemaker Prior to AV Node Ablation, ICD-9

Date: Jul 28, 2014

Question:

With the new pacemaker requirements from CMS taking effect July 7, 2014, I need to know how we should bill for pacemaker implant inserted for atrial fibrillation with future plans of AV node ablation. There are a few physicians who implant pacemakers for a-fib and then ablate the node (in a future procedure), inducing complete heart block, which then makes the patient dependent on the pacemaker. The Medicare instructions specifically state that any pacemaker code (33206, 33207, 33208) billed with 427.31 will be denied. How would you recommend billing this? I don't see how we could use 426.0 (CHB), as the patient isn't in CHB until the AV node is ablated in a future procedure.

Question ID : 5845
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