Abbott Cardiac Rhythm Management Coding and Coverage Resources Instructions

Instructions for Abbott models including: Cardiac Rhythm Management Coding and Coverage Resources, Rhythm Management Coding and Coverage Resources, Management Coding and Coverage Resources, Coding and Coverage Resources, Coverage Resources, Resources

Transvenous Pacemaker Coding Guide

Cardiac Rhythm Management Coding and Coverage Resources | Abbott

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National Pacemaker Guide-v1

CARDIAC RHYTHM MANAGEMENT
National Medicare Reimbursement Guide
Pacemakers E ective January 1, 2024
Information contained herein for DISTRIBUTION in the US ONLY. ©2023 Abbott. All rights reserved. MAT-1901316 v17.0
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TERMS AND CONDITIONS
All content herein may be based upon several sources, included but not limited to primary sources, scientific literature, commercially available data sets, customer supplied information, and external sources.
Estimates shown are for illustrative purposes only. This content is not intended for any other purpose.
It should be noted that there are usually differences between economic modelling actual results. Abbott does not take responsibility for any such discrepancies. There is no guarantee of any potential economic outcome, including payment, cost savings, or procedure volume. Economic outcomes are dependent on many factors and will vary.
Certain Maryland hospitals paid under Maryland Waiver provisions using All Patient Refined Diagnosis Related Group (APR-DRG) are excluded from payment under the Medicare Inpatient Prospective Payment System (IPPS).
Reimbursement Calculators should not be provided at no charge to actively licensed Healthcare Professionals (HCPs) who regularly practice in Vermont.
This information is not to be distributed to third parties.

2024 CRM Medicare Reimbursement Guide

Information contained herein for DISTRIBUTION in the US ONLY. ©2023 Abbott. All rights reserved. MAT-1901316 v17.0
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NATIONAL CARDIAC RHYTHM MANAGEMENT MEDICARE REIMBURSEMENT GUIDE

Effective January 1, 2024

Introduction

Disclaimer

This content is intended to provide reference material related to general guidelines for reimbursement when used consistently with the product's

This material and the information contained herein is for general information purposes only and is not intended, and does not constitute, legal, reimbursement,

labeling. This content includes information regarding coverage, coding and reimbursement. Additional resources can be found at www.cardiovascular.abbott/us/en/hcp/reimbursement.html

business, clinical, or other advice. Furthermore, it is not intended to and does not constitute a representation or guarantee of reimbursement, payment, or charge, or that reimbursement or other payment will be received. It is not intended to

increase or maximize payment by any payer. Abbott makes no express or implied

Biventricular Pacing / Cardiac Resynchronization Therapy (CRT)

warranty or guarantee that the list of codes and narratives in this document is complete or error-free. Similarly, nothing in this document should be viewed as instructions for selecting any particular code, and Abbott does not advocate or

In certain circumstances, an additional lead may be required to achieve pacing of the left ventricle (biventricular pacing). In this event, the additional transvenous lead placement should be separately reported using CPT 33224 or 33225. 33226 is reported for repositioning. See the Cardiac Resynchronization Therapy section for more information.

warrant the appropriateness of the use of any particular code. The ultimate responsibility for coding and obtaining payment/reimbursement remains with the customer. This includes the responsibility for accuracy and veracity of all coding and claims submitted to third-party payers. In addition, the customer should note that laws, regulations, and coverage policies are complex and are updated frequently, and, therefore, the customer should check with its local carriers or

intermediaries often and should consult with legal counsel or a financial, coding,

Reimbursement Hotline

or reimbursement specialist for any questions related to coding, billing, reimbursement, or any related issues. This material reproduces information for

Abbott offers a reimbursement hotline, which provides live coding and

reference purposes only. It is not provided or authorized for marketing use.

reimbursement information from dedicated reimbursement specialists. Coding and

reimbursement support is available Monday through Friday at (855) 569-6430.

Coding and reimbursement assistance is provided subject to the disclaimers set

forth in this content.

2024 CRM Medicare Reimbursement Guide

Information contained herein for DISTRIBUTION in the US ONLY. ©2023 Abbott. All rights reserved. MAT-1901316 v17.0
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PACEMAKERS
Physician

PHYSICIAN CODING PAGE 1 PAGE 2

HOSPITAL OUTPATIENT

AMBULATORY SURGERY CENTER

HOSPITAL INPATIENT ADDITIONAL CODES

CPT CODE
33206 33207 33208
33227 33228
33214
33233
33229

DESCRIPTION
SYSTEM IMPLANT OR REPLACEMENT Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); ventricular Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial and ventricular GENERATOR REMOVAL/REVISION (BATTERY REPLACEMENT) Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator; single lead system Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator; dual lead system SYSTEM UPGRADE: SINGLE CHAMBER TO DUAL CHAMBER PACEMAKER Upgrade of implanted pacemaker system, conversion of single chamber system to dual chamber system (includes removal of previously placed pulse generator, testing of existing lead, insertion of new lead, insertion of new pulse generator) GENERATOR REMOVAL (BATTERY REMOVAL WITHOUT REPLACEMENT) Removal of permanent pacemaker pulse generator only GENERATOR REMOVAL WITH REPLACEMENT Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator; multiple lead system

WORK MEDICARE NATIONAL RATE RVU FACILITY NON-FACILITY

7.14

$439

7.80

$461

8.52

$499

5.25

$328

5.52

$343

7.59

$463

3.14

$227

5.79

$360

NA: Medicare has not established a payment amount for this code. Check with your local Medicare Administrative Contractor (MAC) to verify the payment amount. It is incumbent upon the physician to determine which, if any, modifiers should be used first.

2024 CRM Medicare Reimbursement Guide

Effective Dates: January 1, 2024 - December 31, 2024

PACEMAKERS
Physician

PHYSICIAN CODING PAGE 1 PAGE 2

HOSPITAL OUTPATIENT

AMBULATORY SURGERY CENTER

HOSPITAL INPATIENT ADDITIONAL CODES

CPT CODE
33212 33213
33222
33216 33217 33215 33218 33220 33234 33235

DESCRIPTION
GENERATOR IMPLANT Insertion of pacemaker pulse generator only; with existing single lead Insertion of pacemaker pulse generator only; with existing dual leads RELOCATION OF SKIN POCKET Relocation of skin pocket for pacemaker LEAD PROCEDURES Insertion of a single transvenous electrode, permanent pacemaker or implantable defibrillator Insertion of 2 transvenous electrodes, permanent pacemaker or implantable defibrillator Repositioning of previously implanted transvenous pacemaker or implantable defibrillator (right atrial or right ventricular) electrode Repair of single transvenous electrode, permanent pacemaker or implantable defibrillator Repair of 2 transvenous electrodes for permanent pacemaker or implantable defibrillator Removal of transvenous pacemaker electrode(s); single lead system, atrial or ventricular Removal of transvenous pacemaker electrode(s); dual lead system

WORK MEDICARE NATIONAL RATE RVU FACILITY NON-FACILITY

5.01

$313

5.28

$327

4.85

$333

5.62

$359

5.59

$357

4.92

$300

5.82

$377

5.9

$369

7.66

$467

9.9

$614

2024 CRM Medicare Reimbursement Guide

Effective Dates: January 1, 2024 - December 31, 2024

PACEMAKERS
Hospital Outpatient

PHYSICIAN CODING

HOSPITAL OUTPATIENT PAGE 1 PAGE 2

AMBULATORY SURGERY CENTER

HOSPITAL INPATIENT ADDITIONAL CODES

CPT CODE

SYSTEM IMPLANT OR REPLACEMENT

DESCRIPTION

33206 Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial

33207 Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); ventricular

33208 Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial and ventricular

GENERATOR REMOVAL/REVISION (BATTERY REPLACEMENT)

33227 Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator; single lead system

33228 Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator; dual lead system

SYSTEM UPGRADE: SINGLE CHAMBER TO DUAL CHAMBER PACEMAKER

33214

Upgrade of implanted pacemaker system, conversion of single-chamber system to dualchamber system (includes removal of previously placed pulse generator, testing of existing lead, insertion of new lead, insertion of new pulse generator)

GENERATOR REMOVAL (BATTERY REMOVAL WITHOUT REPLACEMENT)

33233 Removal of permanent pacemaker pulse generator only

GENERATOR REMOVAL WITH REPLACEMENT

33229 Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator; multiple lead system

STATUS APC

MEDICARE

INDICATOR

NATIONAL RATE

5223

$10,185

5223

$10,185

5223

$10,185

5222

$8,103

5223

$10,185

5223

$10,185

5222

$8,103

5224

$18,585

J1: Hospital Part B services paid through a comprehensive APC Q2: T Packaged codes
2024 CRM Medicare Reimbursement Guide

Information contained herein for DISTRIBUTION in the US ONLY. ©2023 Abbott. All rights reserved. MAT-1901316 v17.0
6

Effective Dates: January 1, 2024 - December 31, 2024

PACEMAKERS
Hospital Outpatient

PHYSICIAN CODING

HOSPITAL OUTPATIENT PAGE 1 PAGE 2

AMBULATORY SURGERY CENTER

HOSPITAL INPATIENT ADDITIONAL CODES

CPT CODE
33212 33213
33222
33216 33217 33215 33218 33220 33234 33235

STATUS APC

MEDICARE

INDICATOR

NATIONAL RATE

5222

$8,103

5223

$10,185

5054

$1,739

5222

5183

5221

$8,103 $8,103
$3,040
$3,746 $3,746 $3,746 $3,746

J1: Hospital Part B services paid through a comprehensive APC Q2: T Packaged codes T = Significant procedure, multiple reduction applies
2024 CRM Medicare Reimbursement Guide

Information contained herein for DISTRIBUTION in the US ONLY. ©2023 Abbott. All rights reserved. MAT-1901316 v17.0
7

Effective Dates: January 1, 2024 - December 31, 2024

PACEMAKERS
Ambulatory Surgery Center (ASC)

PHYSICIAN CODING HOSPITAL OUTPATIENT

AMBULATORY SURGERY CENTER PAGE 1 PAGE 2

HOSPITAL INPATIENT ADDITIONAL CODES

CPT CODE 33206 33207 33208
33227 33228
33214
33233
33229

SYSTEM IMPLANT OR REPLACEMENT

DESCRIPTION

PAYMENT MULTI-PROCEDURE MEDICARE

INDICATOR

DISCOUNT

NATIONAL RATE

Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial

$7,223

Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); ventricular

$7,421

Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial and ventricular

$7,639

GENERATOR REMOVAL/REVISION (BATTERY REPLACEMENT)

Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator; single lead system

$6,297

Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator; dual lead system

$7,465

SYSTEM UPGRADE: SINGLE CHAMBER TO DUAL CHAMBER PACEMAKER

Upgrade of implanted pacemaker system, conversion of single-chamber system to dual-chamber system (includes

removal of previously placed pulse generator, testing of existing lead, insertion of new lead, insertion of new pulse

$7,663

generator)

GENERATOR REMOVAL (BATTERY REMOVAL WITHOUT REPLACEMENT)

Removal of permanent pacemaker pulse generator only

$5,580

GENERATOR REMOVAL WITH REPLACEMENT

Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator; multiple lead system

$12,867

J8: Device-intensive procedure; paid at an adjusted rate. 2024 CRM Medicare Reimbursement Guide

Information contained herein for DISTRIBUTION in the US ONLY. ©2023 Abbott. All rights reserved. MAT-1901316 v17.0
8

Effective Dates: January 1, 2024 - December 31, 2024

PACEMAKERS
Ambulatory Surgery Center (ASC)

PHYSICIAN CODING HOSPITAL OUTPATIENT

AMBULATORY SURGERY CENTER PAGE 1 PAGE 2

HOSPITAL INPATIENT ADDITIONAL CODES

CPT CODE
33212 33213
33222
33216 33217 33215 33218 33220 33234 33235

PAYMENT MULTI-PROCEDURE MEDICARE

INDICATOR

DISCOUNT

NATIONAL RATE

$6,316

$7,588

$946

$5,643 $5,430
$1,548
$2,037 $2,662 $2,690 $2,037

A2: Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. G2: Non-office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight J8: Device-intensive procedure; paid at an adjusted rate.

2024 CRM Medicare Reimbursement Guide

Effective Dates: January 1, 2024 - December 31, 2024

PACEMAKERS
Hospital Inpatient

PHYSICIAN CODING HOSPITAL OUTPATIENT

AMBULATORY SURGERY CENTER HOSPITAL INPATIENT ADDITIONAL CODES PAGE 1 PAGE 2 PAGE 3

Note: report the combination of device insertion and/or lead(s) codes that best describes the procedure performed

ICD-10 PCS CODE

DESCRIPTION

PERMANENT CARDIAC PACEMAKER IMPLANT (DRGs 242, 243 AND 244)

0JH60PZ Insertion of cardiac rhythm related device into chest subcutaneous tissue and fascia, open approach

0JH63PZ Insertion of cardiac rhythm related device into chest subcutaneous tissue and fascia, percutaneous approach

0JH80PZ Insertion of cardiac rhythm related device into abdomen subcutaneous tissue and fascia, open approach

0JH83PZ Insertion of cardiac rhythm related device into abdomen subcutaneous tissue and fascia, percutaneous approach

0JH604Z Insertion of pacemaker, single chamber into chest subcutaneous tissue and fascia, open approach

0JH634Z Insertion of pacemaker, single chamber into chest subcutaneous tissue and fascia, percutaneous approach

0JH804Z Insertion of pacemaker, single chamber into abdomen subcutaneous tissue and fascia, open approach

0JH834Z

Insertion of pacemaker, single chamber rate responsive into abdomen subcutaneous tissue and fascia, percutaneous approach

0JH605Z Insertion of pacemaker, single chamber rate responsive into chest subcutaneous tissue and fascia, open approach

0JH635Z Insertion of pacemaker, single chamber rate responsive into chest subcutaneous tissue and fascia, percutaneous approach

TYPICAL MS-DRG ASSIGNMENT

MEDICARE NATIONAL RATE

242 with MCC 243 with CC 244 without CC/MCC

$24,191 $15,947 $12,809

Continued on next page

CC: complication or comorbidity. MCC: a major complication or comorbidity when used as a secondary diagnosis

2024 CRM Medicare Reimbursement Guide

Effective Dates: October 1, 2023 - September 30, 2024

PACEMAKERS
Hospital Inpatient

PHYSICIAN CODING HOSPITAL OUTPATIENT

AMBULATORY SURGERY CENTER HOSPITAL INPATIENT ADDITIONAL CODES PAGE 1 PAGE 2 PAGE 3

Note: report the combination of device insertion and/or lead(s) codes that best describes the procedure performed

ICD-10 PCS CODE

DESCRIPTION

PERMANENT CARDIAC PACEMAKER IMPLANT (DRGs 242, 243 AND 244) (continued)

0JH805Z Insertion of pacemaker, single chamber rate responsive into abdomen subcutaneous tissue and fascia, open approach

0JH835Z

Insertion of pacemaker, single chamber rate responsive into abdomen subcutaneous tissue and fascia, percutaneous approach

0JH606Z Insertion of pacemaker, dual chamber into chest subcutaneous tissue and fascia, open approach

0JH636Z Insertion of pacemaker, dual chamber into chest subcutaneous tissue and fascia, percutaneous approach

0JH806Z Insertion of pacemaker, dual chamber into abdomen subcutaneous tissue and fascia, open approach

0JH836Z Insertion of pacemaker, dual chamber into abdomen subcutaneous tissue and fascia, percutaneous approach

02HK4JZ Insertion of pacemaker lead into right ventricle, percutaneous endoscopic approach

02HK3JZ Insertion of pacemaker lead into right ventricle, percutaneous approach

02HK0JZ Insertion of pacemaker lead into right ventricle, open approach

TYPICAL MS-DRG ASSIGNMENT

MEDICARE NATIONAL RATE

242 with MCC 243 with CC

$24,191 $15,947

244 without CC/MCC

$12,809

CC: complication or comorbidity. MCC: a major complication or comorbidity when used as a secondary diagnosis

2024 CRM Medicare Reimbursement Guide

Effective Dates: October 1, 2023 - September 30, 2024

PACEMAKERS
Hospital Inpatient

PHYSICIAN CODING HOSPITAL OUTPATIENT

AMBULATORY SURGERY CENTER HOSPITAL INPATIENT ADDITIONAL CODES PAGE 1 PAGE 2 PAGE 3

Note: report the combination of device insertion and/or lead(s) codes that best describes the procedure performed

ICD-10 PCS CODE

DESCRIPTION

CARDIAC PACEMAKER DEVICE REPLACEMENT (DRGs 258 AND 259)

0JPT0PZ Removal of cardiac rhythm related device from trunk subcutaneous tissue and fascia, open approach

0JPT3PZ Removal of cardiac rhythm related device from trunk subcutaneous tissue and fascia, percutaneous approach

CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT (DRGs 260, 261 AND 262)

02WA0MZ Revision of cardiac lead in heart, open approach

02WA3MZ Revision of cardiac lead in heart, percutaneous approach

02WA4MZ Revision of cardiac lead in heart, percutaneous endoscopic approach

0JWT0PZ Revision of cardiac rhythm related device in trunk subcutaneous tissue and fascia, open approach

0JWT3PZ Revision of cardiac rhythm related device in trunk subcutaneous tissue and fascia, percutaneous approach

TYPICAL MS-DRG ASSIGNMENT

MEDICARE NATIONAL RATE

258 with MCC 259 without MCC

$18,965 $13,069

260 with MCC 261 with CC 262 without CC/MCC

$23,212 $13,176 $11,520

CC: complication or comorbidity. MCC: a major complication or comorbidity when used as a secondary diagnosis

2024 CRM Medicare Reimbursement Guide

Effective Dates: October 1, 2023 - September 30, 2024

PHYSICIAN CODING HOSPITAL OUTPATIENT AMBULATORY SURGERY CENTER HOSPITAL INPATIENT ADDITIONAL CODES

PACEMAKERS

HCPCS Device Category C-Codes

C-CODE
C1785 C2621 C2620 C1786 C2619
C1883 C1900 C1898 C1779

PACEMAKER GENERATOR IMPLANT Pacemaker, dual-chamber, rate-responsive (implantable) Pacemaker, other than single or dual-chamber (implantable) Pacemaker, single-chamber, non-rate-responsive (implantable) Pacemaker, single-chamber, rate-responsive (implantable) Pacemaker, dual-chamber, non-rate-responsive (implantable) LEADS Adapter/extension, pacing lead or neurostimulator (implantable) Lead, left ventricular coronary venous system Lead, pacemaker, other than transvenous VDD single pass Lead, pacemaker, transvenous VDD single pass

DESCRIPTION

ICD-10-CM Diagnosis Codes
Diagnosis codes are used by both hospitals and physicians to document the indication for the procedure. For Cardiac Pacemaker, Implantable Cardioverter Defibrillator (ICD) and Implantable/Insertable Cardiac Monitors (ICM) patients, there are many possible diagnosis code scenarios and a wide variety of possible combinations. The possible scenarios and combinations are too numerous to capture in this document. The customer should check with their local carriers or intermediaries and should consult with legal counsel or a financial, coding or reimbursement specialist for coding, reimbursement or billing questions related to ICD-10-CM diagnosis codes.

2024 CRM Medicare Reimbursement Guide

Effective Dates: October 1, 2023 - September 30, 2024

REFERENCES
1. FY2024 IPPS Final Rule Home Page. U.S. Centers for Medicare and Medicaid Services. [cited: September 2023]. https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/fy-2024-ipps-final-rule-home-page
2. CY2024 ASC Final Notice Home Page. U.S. Centers for Medicare and Medicaid Services. [cited: November 2023]. https://www.cms.gov/medicare/payment/prospective-payment-systems/ambulatory-surgical-center-asc/asc-regulations-and-notices
3. CY2024 MPFS Final Rule Home Page. U.S. Centers for Medicare and Medicaid Services. [cited: November 2023]. https://www.cms.gov/medicare/payment/fee-schedules/physician/federal-regulation-notices
4. CY2024 OPPS Final Rule Home Page. U.S. Centers for Medicare and Medicaid Services. [cited: November 2023]. https://www.cms.gov/medicare/payment/prospective-payment-systems/hospital-outpatient/regulations-notices
5. FY2023 IPPS Final Rule Home Page. U.S. Centers for Medicare and Medicaid Services. [cited: August 2022]. https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/fy-2023-ipps-final-rule-home-page
6. CY2023 OPPS Final Rule with Correction Notice. U.S. Centers for Medicare and Medicaid Services. [cited: November 2023].
https://www.cms.gov/medicare/payment/prospective-payment-systems/hospital-outpatient/regulations-notices 7. Provider Outpatient Hospital Charge Data by APC, CY2021. [cited: November 2023].
https://data.cms.gov/provider-summary-by-type-of-service/medicare-outpatient-hospitals/medicare-outpatient-hospitals-by-provider-and-service 8. Medicare Inpatient Hospitals - by Provider and Service - FY2021 [cited: Sept 2023].
https://data.cms.gov/provider-summary-by-type-of-service/medicare-inpatient-hospitals/medicare-inpatient-hospitals-by-provider-and-service 9. HOSPITAL ACUTE INPATIENT SERVICES PAYMENT SYSTEM - PAYMENT BASICS [cited: September 2023]
https://www.medpac.gov/wp-content/uploads/2021/11/MedPAC_Payment_Basics_22_hospital_FINAL_SEC.pdf 10. CGS Medicare Part B Fees [cited: January 2021].
https://www.cgsmedicare.com/partb/fees/index.html 11. First Coast Service Options (FCSO) Medicare Part B Fees [cited: January 2021].
https://medicare.fcso.com/SharedTools/faces/FeeSchedule_en.jspx?lob=&state= 12. National Government Services (NGS) Medicare Fee Schedule Lookup [cited: September 2023].
https://www.ngsmedicare.com/web/ngs/fee-schedules-and-pricers?lob=93617&state=97256&region=93623 13. Noridian Healthcare Solutions Medicare Contractor Status Codes (C-Status) [cited: January 2021].
https://med.noridianmedicare.com/web/jeb/fees-news/fee-schedules/contractor-status-codes-c-status 14. Novitas Solutions Medicare Physician's Fee Schedule [cited: September 2023].
https://www.novitas-solutions.com/webcenter/portal/MedicareJH/FeeLookup 15. Palmetto GBA Medicare Physician Fee Schedule Part B [cited: January 2021].
https://www.palmettogba.com/palmetto/fees_front.nsf/fee_main?OpenForm 16. WPS Medicare Physician Fee Schedules [cited: January 2021].
https://www.wpsgha.com/wps/portal/mac/site/fees-and-reimbursements/guides-and-resources/2021-mpfs/!ut/p/z0/fczRCoMgFIDhJ5JjDqTbNhouku1q2LmJwzKTNhWtPf96gl3-8PEDggEM9PWONh8DvY8eUI4PpaSqat7fhea80dfnqa37862R0AH-B8dBZH 3RDjDRtjAf5gjG7X6yhVGYWLYl7vllCxjBRcU-aS6QVhx-vBlflA!!/

2024 CRM Medicare Reimbursement Guide

Information contained herein for DISTRIBUTION in the US ONLY.
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References

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