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Cardiology Coding Alert

You Be the Expert:

Does Pacemaker Placement Route Matter?

Question: I have an operative report for a dual pacemaker implant in which the cardiologist did not place the pacemaker through superior access as usually would occur. Instead, he placed the pacemaker abdominally. Should I still use 33208 and 71090? Florida Subscriber           Answer: You don't need to adjust your codes, because nothing in the code description says that the cardiologist must place the pacemaker in the chest through upper vessels. You would report 33208 (Insertion or replacement of permanent pacemaker with transvenous electrode[s]; atrial and ventricular) for a generator with both right atrial and right ventricular leads. Don't forget: You'll report the fluoroscopy using 71090-26 (Insertion pacemaker, fluoroscopy and radiography, radiological supervision and interpretation; professional component) only when your cardiologist documents it in the operative report.

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