Physician Reimbursement Primer for Cardiac ... - Boston Scientific

More documents

Recommendations

Info

Chapter 6 resistance 577, threshold .4 volts at .5 with a shock resistance 41. The safe sheath was passed over the guide wire and threw it the rapid 0 sheath passed to the right atrium. A quadripolar electrode was used under simultaneous fluoroscopic and electrical monitoring to easily engaged the coronary sinus. The electrode was replaced with the balloon catheter and using 10 cc of Omnipaque a coronary sinus venogram was obtained. Approximately one hour and 30 minutes of time was next to utilize to engage one of the lateral branches off the coronary sinus tract the middle veins arose from an excessively acute angle and although the guide wire could be passed, the electrode would not tract along it. The upper veins repeatedly produced diaphragmatic\E\phrenic nerve stimulation. Eventually, a more medial branch of one of the upper lateral veins accepted the Easy Track model 4538 electrode without phrenic nerve stimulation. That left ventricular lead had a threshold of 3.5 volts, resistance 609 and R waves 3.4. With a finishing wire in place the sheath was cut free without disturbing electrode. The safe sheath was broken free. With the retained guide wire the atrial lead was inserted using a model 44 7 0 and positioned in the right atrial appendage with P. waves 4.0, resistance 432 and threshold .4 volts. The device was a Contak Renewal 3 model2. All of the electrodes were placed into the device, the set screws tightened and normal sensing and pacing confirmed. The device fit comfortably in the pocket in the subcutaneous tissue was approximated with interrupted 3 0 Vicryl. The anesthesiologist induced anesthesia and a single shock of 21 joules produced conversion of the ventricular fibrillation which had been induced by a shock on T. The wound was stable and dressed. The patient awoke from anesthesia. He was transferred to his room. There are no complications. Outpatient Coding: Procedures CPT Codes Implantation of biventricular defibrillator 33249 Fluoroscopy 71090 Insertion of LV lead via coronary sinus 33225 DFT testing 93641 *Individual symptoms, situations, circumstances, and results may vary. This information is not intended to be used for medical diagnosis or treatment or as a substitute for professional medical advice. Patients should consult a physician or qualified health care provider regarding their medical condition and appropriate medical treatment. This information is to be used in conjunction with other resource material, which may include the applicable patient handbook, device physician's manual, and any implant accessories instructions for use. 48 Physician Reimbursement Primer for Cardiac Rhythm Management
References Clinical Case References Examples 1 Centers of Medicare and Medicaid Services. Glossary (search “Medical Necessity”). Last modified May 14, 2006. Available at: www.cms.hhs.gov/apps/glossary/default.asp?Letter =M&Language=English. Accessed June 15, 2009. 2 Centers for Medicare and Medicaid Services. Glossary (search “Medicare”). Last modified July 27, 2005. Available at: http://www.cms.hhs.gov/apps/glossary/default.asp?Letter= M&Language=English. Accessed June 15, 2009. 3 Schmidt K, Ramsdell S, eds. DRG Expert: A comprehensive guidebook to the DRG classification system. 25th ed. Ingenix,Inc.; 2008. 4 Centers for Medicare and Medicaid Services. Final Changes to the Hospital Outpatient Prospective Payment System and CY2008 Payment Rates; Final Rule CMS-1392-FC, Federal Register November 1, 2007; 42 CFR Parts 410, 411, 412, 413, 414, 416, 419, 482, and 485. Available at: http://www.cms.hhs.gov/HospitalOutpatientPPS/ Downloads/cms1392fc.pdf. Accessed June 15, 2009. 5 Centers for Medicare and Medicaid Services. National Coverage Determination for Cardiac Pacemakers (20.8). In: Medicare Coverage Database. Effective April 30, 2004. Available at: http://www.cms.hhs.gov/mcd/viewncd.asp?ncd_id=20.8&ncd_version =2&basket=ncd%3A20%2E8%3A2%3ACardiac+Pacemakers. Accessed June 15, 2009. 6 Centers for Medicare and Medicaid Services. National Coverage Determination for Cardiac Pacemaker Evaluation Services (20.8.1). In: Medicare Coverage Database. Effective October 1, 1984. Available at: http://www.cms.hhs.gov/mcd/viewncd.asp?ncd_ id=20.8.1&ncd_version=1&basket=ncd%3A20%2E8%2E1%3A1%3ACardiac+Pacemaker +Evaluation+Services. Accessed June 15, 2009. 7 Centers for Medicare and Medicaid Services. Coverage determinations: Transtelephonic monitoring of cardiac pacemakers.In: Medicare National Coverage Determinations Manual. CMS Pub. 100-3; Chapter 1, Part 1, Section 20.8.1.1. October 3, 2003. Available at:.http://www.cms.hhs.gov/manuals/downloads/ncd103c1_Part1.pdf. Accessed June 15, 2009. 8 Centers for Medicare and Medicaid Services. National Coverage Determination for Implantable Automatic Defibrillators (20.4).In: Medicare Coverage Database. Effective January 27, 2005. Available at: http://www.cms.hhs.gov/mcd/viewncd.asp?ncd_id= 20.4&ncd_version=3&basket=ncd%3A20%2E4%3A3%3AImplantable+ Automatic +Defibrillators and http://www.cms.hhs.gov/transmittals/downloads/R29NCD.pdf. Accessed June 15, 2009. 9 Heart Rhythm Society. Expanded ICD Coverage for Primary Prevention, February 23, 2005. Available at: http://www.hrsonline.org/Policy/ICDRegistry/. Accessed June 15, 2009. 10 American Medical Association. Current Procedural Terminology (CPT®) 2009. Professional Edition. Chicago, IL: 2008. Physician Reimbursement Primer for Cardiac Rhythm Management 49
Page 1 and 2:
GuidePoint GuidePoint is simplifyin
Page 3 and 4: Contents Chapter 1: Introduction ..
Page 5: How This Guide Is Organized Ablatio
Page 8 and 9: Chapter 1 Acronym Term CRM cardiac
Page 10 and 11: Chapter 2 detail below). This payme
Page 12 and 13: Chapter 2 procedure, the hemodynami
Page 14 and 15: Chapter 2 MS-DRG Logic for CRM Proc
Page 16 and 17: Chapter 2 10 Physician Reimbursemen
Page 18 and 19: Chapter 3 relatively rare, they can
Page 20 and 21: Chapter 3 3. Sino-atrial block or s
Page 22 and 23: Chapter 3 Since there are more than
Page 24 and 25: Chapter 3 c. Ejection fractions mus
Page 26 and 27: Chapter 3 At this time there is no
Page 28 and 29: Chapter 3 Cardiac Resynchronization
Page 30 and 31: Chapter 4 because the physician may
Page 32 and 33: Chapter 5 • Disconnection of lead
Page 34 and 35: Chapter 5 • Temporary pacing is n
Page 36 and 37: Chapter 5 Pacemaker Revision to Ski
Page 38 and 39: Chapter 5 ICD Generator Replacement
Page 40 and 41: Chapter 5 individual payers regardi
Page 42 and 43: Chapter 5 Outpatient Procedure Codi
Page 44 and 45: Chapter 5 • Do not report this co
Page 46 and 47: Chapter 5 • Assign modifier 26 to
Page 48 and 49: Chapter 5 • Code 93652 is reporte
Page 52 and 53: Chapter 6 Case Study 3 Procedure De
show all

Physician Reimbursement Primer for Cardiac ... - Boston Scientific

Create successful ePaper yourself

Delete template?

Save as template?