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intraoperative lead testing

Janet Posted Wed 30th of April, 2014 11:33:46 AM

what code do you use for Intraoperative epicardial left ventricular lead analysis and tesing. A physician outside of our practice performed a surgery and we went in and performed analysis and testing. Thanks!

SuperCoder Answered Wed 30th of April, 2014 23:40:38 PM

Please confirm whether it's a pacemaker or ICD. Also confirm whether "intraoperative" means initial placement session.

Thanks

Janet Posted Thu 01st of May, 2014 08:38:01 AM

It's an ICD. They are going to upgrade to BiV. The cardiothoracic surgeon placed the lead when performing a CABG for a later upgrade. Thanks!

SuperCoder Answered Thu 01st of May, 2014 15:11:42 PM

93640 is more well-fit code in this case since there is no mention of an ICD pulse generator.

As per CPT Assistant June 2000; Volume 10: Issue 6, --> "programming" (93640-93641) of pacing cardioverter-defibrillator systems is additionally reported at the time of insertion or replacement... The assessment and reassessment of the pacing cardioverter-defibrillator electrodes related to sensing, pacing and electrode impedance characteristics at the time of insertion, repair, revision or replacement is additionally reported using codes 93640-93641.

"Codes 93640 and 93641 are intended to be reported in addition to the appropriate insertion code(s) at the time of implantation or replacement of the single or dual chamber pacing cardioverter defibrillator electrode leads (93640) or pulse generator (93641)."

"Code 93640 is reported when the pacing cardioverter-defibrillator electrode leads are implanted during insertion but are not connected to the pulse generator. When a pulse generator is connected and the entire system is tested, then code 93641 is reported."

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