Can I bill 33208-KX and 33284 on same claim?

Can I bill cpt code 33208-KX (placement of dual pacemaker) and 33284 (removal of pacemaker)on the same claim? If so, would I need to attach a modifier on 33284?

Comments

  • edited May 2017
    YES IF REINSERTING WHOLE SYSTEM. I WOULD SAY NO ON THE MODIFIER AS IT IS
    A REMOVAL
  • No, if you remove a PM and replace with a dual you would be billing 33228, placement and removal bundle into one code. 
  • edited May 2017
    sorry i miss read that
  • No. Remove and replace is 33228. It encompasses the removal of the old pacer and the placement of the new.


    Camille Laabs, CPC
    Hospital Billers Team Lead
    Cardiac Study Center, Inc., P.S.
    1901 S Cedar St  Ste 301
    Tacoma WA  98405
    253-572-7320 ext 3049
  • I'm new at this and I want to make sure I understand this correctly. A modifier is not necessary because it bundles into the 33208? I looked on the NCCI table, I was unable to find where 33284 and 33208 was bundling. Also, in the cpt code book I read that procedure code 33228 is for a removal of permanent pacemaker pulse genator with replcement of pacemaker pulse generator, dual lead system. Since 33284 is a patient-activated event recorder would this be consider to be a permanent pacemaker pulse generator?

    Should I have billed 33228 instead of 33208-kx and 33284?

    Thanks
  • edited May 2017
    were the leads also replaced?
  • I'm so sorry, I misunderstood. Yes, you can bill 33208 and 33284 on the same claim. You should not need a modifier for the 33284. We bill that combo frequently with no denials.

    Camille Laabs, CPC
    Hospital Billers Team Lead
    Cardiac Study Center, Inc., P.S.
    1901 S Cedar St  Ste 301
    Tacoma WA  98405
    253-572-7320 ext 3049
  • Do you apply the KX modifier to 33208 and 33284 without a modifier?

    Thanks
  • The -KX modifier on the 33208 is for Medicare only and the 33284 does not need a modifier


    Kelly Byrd, CPC
    Physician Services Coder
    Northern California Medical Associates
    Phone: 707 573-6150 Ext 306
    Fax: 707 573-6160
    kelly.byrd@ncmahealth.com
  • I have another question concerning this procedure. I know it has a 90 day global period. If the procedure was performed on 11/04/15 and the patient had an office visit and EKG done on 11/23/15. The patient came in for a new onset symptoms. Do I bill the E/M code with just a 24 modifier or a 25 and 24 modifier?

    Thanks
  • The EKG doesn't require the 25 modifier so just use the 24 modifier.

    Paula M. Noble
    Front End Revenue Cycle Supervisor
    MSRDP
    LB.2314
    469-291-2257 - phone
    469-291-2392 - fax
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