Cardiology Question for the Week of October 5, 2015

Question:

Question:

Can code 33210 be assigned for a temporary pacemaker insertion if the reason the patient came to the hospital was bradycardia? A left heart catheterization (93452) was performed following the temporary pacemaker insertion.

Answer:

For physician billing, the answer is no. There is a national correct coding initiative (CCI) edit for physician billing that does not allow 33210 to be assigned with 93452 under any circumstances. For hospital billing, the CCI edit does allow the two codes to be assigned together under some circumstances.   

For example, the two codes may be reported together when a patient has a temporary pacemaker inserted in an emergency setting and must be monitored until a decision is made for an appropriate definitive surgery. The insertion of the temporary pacemaker is at a separate session and requires routine care involving regular cardiovascular assessment, level of consciousness, heart rhythm, pacer activity and hemodynamic response. Following this monitoring period, a subsequent procedure or surgery may be performed at a separate session from the temporary pacemaker insertion.

The temporary pacemaker code would need a 59 modifier to indicate that it was at a separate session.

Answer: