Cardiology Question for the Week of March 26, 2018

Question:

What code should be assigned when a battery is replaced for a pacemaker?

Answer:

When a “battery” is replaced, it is actually the pulse generator that is being replaced. Hybrid codes have been created for the exchange. These codes include the removal and replacement of the battery only during the same encounter when chronic leads are used.

For example:

For exchange of single-lead pulse generator:

For outpatient prospective payment system (OPPS) billing, add the HCPCS code for the implanted device:

Or

For the dual-lead pulse generator:

For OPPS billing, add the HCPCS code for the implanted device:

Or

For the multiple-lead pulse generator:

For OPPS billing, add the HCPCS code for the implanted device:

The parenthetical under codes 33227, 33228, 33229 states:

(Do not report 33227, 33228, 33229 in conjunction with 33214, 33216, 33217, 33233)

(For removal and replacement of pacemaker pulse generator and transvenous electrode(s), use 33233 in conjunction with either 33234 or 33235 and 33206 – 33208)

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