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Upgrade of DDD pacemaker to DDD-ICD with CRT

Carl Posted Wed 10th of February, 2016 15:42:35 PM

DDD pacemaker pulse generator replacement and upgrade to a DDD-ICD-CRT.
Transvenous Lead extraction of the RV pacemaker lead.
Placement of a new RV defibrillator lead.
Placement of a new LV lead in cardiac venous system.
Defibrillation threshold done.

Patient presents for replacement and upgrade of his DDD pacemaker pulse generator to a BiV DDD-ICD-CRT..

He has CHF and LVEF <35%. He is pacemaker dependent.
A new RV defibrillator lead is inserted.
The old DDD pacemaker pulse generator is removed and a new DDD-ICD-CRT pulse generator is inserted.
The existing RV pacemaker lead is removed by transvenous extraction with a Laser sheath in the Hybrid room.
A new cardiac venous LV pacing lead is inserted.
The new device is connected to the existing RA lead, the new RV defibrillator lead and new LV lead.
Defibrillation testing is done using the new DDD-ICD-CRT device.

CODES: 33249, 33234, 33225, 33233, 93641-26

Is this the right CPT codes sequence?
Is it 93641 or 93641-26?

SuperCoder Answered Thu 11th of February, 2016 07:37:26 AM

Yes this CPT codes sequence seems correct for the given situation. It should be 93641-26, as this code takes modifier 26, per the Medicare Physician Fee Schedule.

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