AHA Coding Clinic® for ICD-9 - 2007 Issue 1; Ask the Editor

Biventricular Defibrillator Insertion and Coronary Sinus Mapping Angiography

The patient is a 78-year-old male with chronic congestive heart failure and ischemic cardiomyopathy. The patient was admitted for upgrade of his current dual chamber implantable cardioverter/defibrillator (ICD) to a biventricular pacemaker with defibrillator device. During the surgery, ICD pocket revision, insertion of biventricular/ICD generator with left ventricle (LV) lead, and coronary sinus mapping and right coronary angiography were performed. Could you please advise on the correct code assignments for implantation of biventricular pacemaker device performed in conjunction with coronary sinus mapping/angiography? Coding Clinic Third Quarter 2001, pages 4-5, states, “In many cases, a left coronary angiogram (i.e., venogram) is required to illuminate and diagnose the coronary venous system before inserting the left ventricle lead.” However, the Coding Clinic did not go on to explain whether coronary sinus mapping with angiography is inherent to the procedure. What are the appropriate procedure code assignments? ...

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