Revised Cardiac Pacemaker Procedures (37.70-37.89), Effective October 1987

The following coding guidelines for the revised cardiac pacemaker procedure codes are effective as of October 1, 1987, on all discharges occurring after September 30, 1987. Category 99.7 Cardiac pacemaker battery and sensing types, is deleted as of October 1, 1987. Cardiac pacemaker therapy is the electrical control of the heart rate (pacing). It is carried out to improve cardiac output, prevent asystole (cardiac standstill), suppress ventricular irritation, and treat conduction disorders and arrhythmias. Cardiac pacing therapy may be temporary or permanent in nature. ICD-9-CM code assignments differentiate temporary from permanent cardiac pacing procedures. The pacemaker device is...

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Note:  The following article synopsis was NOT provided by the AHA. It was created by Find-A-Code/innoviHealth.

Article Overview

This article explains revised cardiac pacemaker procedure coding guidance effective October 1, 1987, with emphasis on ICD-9-CM procedure coding for temporary pacing, permanent pacemaker insertion, lead and device replacement, pocket revision, and device removal. It is intended for hospital coders, HIM staff, and reimbursement personnel who need to understand how pacemaker-related procedures were categorized and reported in the Medicare era. The article also addresses documentation and reporting topics tied to pacemaker DRG assignment and mentions later-dated updates to certain pocket-related diagnoses.

Why This Topic Matters

Pacemaker procedure coding affected hospital reimbursement, DRG assignment, and consistent reporting of device-and-lead combinations. Understanding this historical guidance helps with accurate retrospective coding, record review, and interpretation of legacy medical records.

Article Sections

  1. Overview and scope of the revised pacemaker codes

    Introduces the effective date of the revised cardiac pacemaker procedure guidance and the general scope of the article. It also notes the historical deletion of an older category and summarizes the broad purpose of the update.

  2. Temporary cardiac pacing

    Describes temporary pacing procedures and how temporary systems are distinguished from permanent pacemaker procedures. It includes general discussion of procedure categories and related reporting considerations.

  3. Initial insertion of permanent cardiac pacemaker system

    Covers the initial implantation of permanent pacemaker systems and the need to identify both device and lead components. It discusses approaches used for insertion and the relationship to coding completeness.

  4. Replacement of cardiac pacemaker lead

    Addresses replacement of pacemaker leads and the related handling of existing leads. It discusses broad categories of lead replacement scenarios.

  5. Revision of cardiac pacemaker lead

    Summarizes lead revision situations involving removal, repair, reinsertion, or repositioning. It also notes a temporary lead scenario that is not separately coded.

  6. Removal of cardiac pacemaker lead without replacement

    Discusses removal of pacemaker leads when no replacement is performed. It includes mention of both transvenous and epicardial lead removal contexts.

  7. Initial insertion of cardiac pacemaker device

    Explains how the pacemaker device component is categorized for initial implantation. It describes the general device types referenced in the article and related documentation issues.

  8. Replacement of cardiac pacemaker device

    Covers replacement of an existing pacemaker device with a new device and the distinction between device replacement and pocket revision. It also notes device-type categories discussed in the article.

  9. Revision or removal of cardiac device

    Describes removal or repair/reinsertion situations involving the pacemaker device. It also addresses cases where device and lead removal occur together.

  10. Total replacement of a permanent pacemaker system

    Summarizes complete system replacement as a combination of device and lead components. It notes broad reasons why a total replacement might occur.

  11. Revision or relocation of cardiac pacemaker pocket

    Covers procedures involving debridement, refashioning, revision, or relocation of the pocket that holds the pacemaker device. It also mentions later updates affecting pocket-related diagnosis coding.

  12. Initial insertion of a pacemaker transvenous lead only

    Discusses the unusual situation where a transvenous lead is documented without a simultaneous device insertion. It emphasizes record review and physician verification concerns.

  13. Replacement of a pacemaker device battery

    Explains how battery replacement terminology is treated in pacemaker device reporting. It frames this as a device replacement issue in the historical guidance.

  14. Reprogramming of a programmable cardiac pacemaker device

    Addresses reprogramming and adjustment of pacemaker functions. It also notes the associated diagnostic coding concept mentioned in the article.

What You Will Learn

  • How the revised pacemaker procedure guidance is organized by procedure type.
  • What broad distinctions the article makes between temporary and permanent pacing.
  • How device, lead, and pocket-related pacemaker procedures are grouped in the guidance.
  • What documentation and reporting issues are highlighted for hospital coding and Medicare payment.

Who Should Read This

  • Hospital coders
  • Health information management professionals
  • Medical record staff
  • Reimbursement specialists
  • Clinical documentation staff

Codes Discussed

  • ICD-9-CM: 99.7
  • ICD-9-CM: 37.78
  • ICD-9-CM: 39.64
  • ICD-9-CM: 88.50
  • ICD-9-CM: 88.58
  • ICD-9-CM: 37.21
  • ICD-9-CM: 37.23
  • ICD-9-CM: 37.70
  • ICD-9-CM: 37.74
  • ICD-9-CM: 37.75
  • ICD-9-CM: 37.76
  • ICD-9-CM: 37.77
  • ICD-9-CM: 37.79
  • ICD-9-CM: 37.80
  • ICD-9-CM: 37.81
  • ICD-9-CM: 37.82
  • ICD-9-CM: 37.83
  • ICD-9-CM: 37.85
  • ICD-9-CM: 37.86
  • ICD-9-CM: 37.87
  • ICD-9-CM: 37.89
  • ICD-9-CM Diagnosis: V53.3
  • ICD-9-CM Diagnosis: 996.61
  • ICD-9-CM Diagnosis: 996.72
  • ICD-9-CM Diagnosis: 996.6
  • ICD-9-CM Diagnosis: 996.7

Code Ranges Discussed

  • ICD-9-CM: 37.70-37.74
  • ICD-9-CM: 37.80-37.83
  • ICD-9-CM: 37.71-37.73
  • ICD-9-CM: 37.85-37.87
  • ICD-9-CM: 37.78 or 39.64
  • ICD-9-CM: 88.50-88.58
  • ICD-9-CM: 37.21-37.23

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