AHA Coding Clinic® for HCPCS - 2010 Issue 2

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A patient presented to have a biventricular pacemaker inserted. According to the operative report the coronary sinus vein was finally accessed after multiple attempts to cannulate the coronary sinus vein were made. A venogram revealed that the coronary sinus vein had a couple of branches appropriate for implantation of a coronary sinus lead. Unfortunately, none of the branches accessed were effective in pacing the patient. It was a very prolonged attempt for implantation of the Cardiac Resynchronization Therapy-Pacemaker (CRT-P) and because the patient was in persistent long-standing atrial fibrillation, the right atrial lead could not be implanted. Therefore, a single-chamber pacemaker was successfully attached to the right ventricular lead and implanted. What are the appropriate CPT codes and modifiers for this scenario? ...

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