Question: Which ICD9 Code should be used for a pacemaker battery change when the instrument has stopped working? Answer: The most appropriate code for replacement at the end of the expected battery life is V53.31 (Fitting and adjustment of cardiac pacemaker).
Z45.018 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Short description: Encounter for adjust and mgmt oth prt cardiac pacemaker. The 2021 edition of ICD-10-CM Z45.018 became effective on October 1, 2020.
Claims for pacemaker claims that do not meet the criteria for modifier – KX or – SC should have modifier – GA or – GZ appended depending on the ABN status and will be denied. Group 1 CPT codes apply to Groups 1 and 2 ICD-10-CM Codes.
It is expected that a battery will last only so long so replacing it is not considered a “complication” when replacement is needed. You could also report Z45.49 (Encounter for adjustment and management of other implanted nervous system device) as a secondary diagnosis code but it would not be the primary diagnosis.
The replacement of a battery or pulse generator requires two codes, one for the removal and another for the insertion. You'd pick 33212 or 33213, depending on whether it's a single or dual chamber, and 33233.
Breakdown (mechanical) of cardiac pulse generator (battery), initial encounter. T82. 111A is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM T82.
The ICD-10-PCS code assignment for this case example is:0JH606Z, Insertion of pacemaker generator.02H63JZ, Insertion of device in atrium.02HK3JZ, Insertion of device in ventricle.
Z95.0Z95. 0 - Presence of cardiac pacemaker | ICD-10-CM.
Group 1CodeDescription33249INSERTION OR REPLACEMENT OF PERMANENT IMPLANTABLE DEFIBRILLATOR SYSTEM, WITH TRANSVENOUS LEAD(S), SINGLE OR DUAL CHAMBER33262REMOVAL OF IMPLANTABLE DEFIBRILLATOR PULSE GENERATOR WITH REPLACEMENT OF IMPLANTABLE DEFIBRILLATOR PULSE GENERATOR; SINGLE LEAD SYSTEM23 more rows
Pacemaker or Implantable Defibrillator ProceduresCPT® 33241, Under Pacemaker or Implantable Defibrillator Procedures. The Current Procedural Terminology (CPT®) code 33241 as maintained by American Medical Association, is a medical procedural code under the range - Pacemaker or Implantable Defibrillator Procedures.
33227 Removal of permanent pacemaker with replacement of pacemaker; single lead system for removal of the pulse generator and a code for the insertion of the pulse generator. CPT copyright American Medical Association.
Pacemaker codesLetter 1: chamber that is paced (A = atria, V = ventricles, D = dual-chamber).Letter 2: chamber that is sensed (A = atria, V = ventricles, D = dual-chamber, 0 = none).Letter 3: response to a sensed event (T = triggered, I = inhibited, D = dual - T and I, R = reverse).More items...•
ICD-10-PCS will be the official system of assigning codes to procedures associated with hospital utilization in the United States. ICD-10-PCS codes will support data collection, payment and electronic health records. ICD-10-PCS is a medical classification coding system for procedural codes.
33206 Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial.
33228. Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator; dual lead system. For OPPS billing, add the HCPCS code for the implanted device: C2619.
Generator Replacement When the pulse generator is replaced and the new generator is attached to the existing subcutaneous lead, the procedure is reported with code 33262 (Removal of implantable defibrillator pulse generator with replacement of implantable defibrillator pulse generator; single lead system).
CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.
Abstract: The National Coverage Determination (NCD) 20.8.3, Single Chamber and Dual Chamber Permanent Cardiac Pacemakers were revised with an effective date of August 13, 2013. The CMS A/B Medicare Administrative Contractors (MACs) have been instructed to implement the NCD at the local level.
Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type.
Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination.