CRT-D Coding

Cardiac Resynchronization System (CRT-D) Vol.3 Procedure Codes

Hospital Inpatient:

ICD-9-CM Volume 3 Procedure Code Options:

Implantation or Replacement of Total System

00.51 Implantation of cardiac resynchronization defibrillator, total system [CRT-D]

Implantation or Replacement of CRT-D Generator Only

00.54 Implantation or replacement of cardiac resynchronization defibrillator, pulse generator only [CRT-D]

Implantation or Replacement of LV Lead Transvenous

00.52 Implantation or replacement of transvenous lead [electrode] into left ventricular coronary venous system

Implantation or Replacement of RA, RV or LV Lead, Epicardial

37.74 Insertion or replacement of epicardial lead (electrode) into epicardium*

Insertion or Replacement of RA or RV Lead, Transvenous

37.95 Implantation of automatic cardioverter/defibrillator lead(s) only

37.97 Replacement of automatic cardioverter/defibrillator lead(s) only

Revision or Repositioning of RA, RV or LV lead

37.75 Revision of lead (electrode)**

Revision or Relocation of Pocket

37.79 Revision or relocation of cardiac device pocket

Removal of CRT-D Device Without Replacement

37.99 Other operations on heart and pericardium

Diagnostic Electrophysiologic Procedure and Intracardiac Device Testing with Induction of Arrhythmia

37.26 Cardiac electrophysiologic stimulation and recording studies (including NIPS)

Device Checks Without Induction of Arrhythmia

89.49 Automatic implantable cardioverter/defibrillator (AICD) check

AV Optimization of Biventricular Devices

88.72 Diagnostic ultrasound of the heart

CRT-P Procedures

Cardiac Resynchronization System (CRT-P) Vol.3 Procedure Codes

Hospital Inpatient:

ICD-9-CM Volume 3 Procedure Code Options:

Implantation or Replacement of Total System

00.50 Implantation of cardiac resynchronization pacemaker without mention of defibrillation, total system [CRT-P]

Implantation or Replacement of CRT-P Generator Only

00.53 Implantation or replacement of cardiac resynchronization pacemaker, pulse generator only  [CRT-P]

Implantation or Replacement of LV Lead, Transvenous

00.52 Implantation or replacement of transvenous lead [electrode] into left ventricular coronary venous system

Implantation or Replacement of RA, RV or LV Lead, Epicardial

37.74 Insertion or replacement of epicardial lead (electrode) into epicardium**

Insertion or Replacement of Other (RA and RV) Lead

37.70 Initial insertion of lead [electrode], not otherwise specified

37.71 Initial insertion of transvenous lead [electrode] into ventricle

37.72 Initial insertion of transvenous leads [electrodes] into atrium and ventricle

37.73 Initial insertion of transvenous lead [electrode] into atrium

37.74 Insertion or replacement of epicardial lead [electrode] into epicardium

37.76 Replacement of transvenous atrial and/or ventricular lead(s) [electrode]

Unspecified Insertion or Replacement of Lead

37.70 Initial insertion of lead [electrode], not otherwise Specified

Revision or Repositioning of RA, RV or LV lead

37.75 Revision of lead (electrode)

Revision and Removal of Lead

37.75 Revision of lead [electrode]

37.77 Removal of lead(s) [electrode] without replacement

Revision or Relocation of Pocket

37.79 Revision or relocation of cardiac device pocket

Revision or Removal of CRT-P Generator

37.89 Revision or removal of pacemaker device

Device Checks

89.45 Artificial pacemaker rate check

89.46 Artificial artifact waveform check

89.47 Artificial pacemaker electrode impedance check

89.48 Artificial pacemaker voltage or amperage threshold Check

Intracardiac Device Testing with Induction of Arrhythmia

37.26 Cardiac electrophysiologic stimulation and recording studies (including NIPS)

AV Optimization of Biventricular Devices

88.72 Diagnostic ultrasound of the heart

HIP Replacement Bearing Surface Vol.3 Codes

Vol.3 Hip Replacement Bearing Surface Codes:

To the best of our knowledge, there is no centralized resource that does exactly what you request.  As an attempt to remedy this situation, we have a compiled a list below of the most commonly used manufacturers and their bearing surface products matching them to the materials described in the new ICD-9 CM procedure codes:

00.74  Hip replacement bearing surface, metal on polyethylene

Biomet (biomet.com)

       Endo II cobalt chrome femoral head

       Modular cobalt chrome femoral head

       Offset cobalt chrome femoral head

       ArCom polyethylene liners

       ArComXL highly cross-linked polyethylene liners

DePuy Orthopedics, Inc. (depuy.com)

       Articuleze cobalt chrome femoral heads

       Enduron polyethylene liners

       Marathon cross-linked polyethylene liners

Hayes Medical (hayesmed.com)

       Cobalt chrome femoral heads

       Millennium cross-linked polyethylene liners

Plus Orthopedics (plusortho.com)

       Cobalt chromium femoral heads

Smith & Nephew (smith-nephew.com)

       Cobalt chrome femoral heads

       Reflection polyethylene liners 

       Reflection XLPE (cross-linked polyethylene liners)

Stryker Corporation (stryker.com)

       C-Taper cobalt chrome femoral heads

       LFIT (Low Friction Ion Treatment) cobalt chromium femoral heads

       V40 Vitallium femoral heads

       Crossfire XLPE (highly cross-linked polyethylene liners)

       Trident constrained polyethylene inserts

       Trident Eccentric polyethylene inserts

       X3 polyethylene liners

Zimmer (zimmer.com)

       Continuum superpolished 12/14 femoral heads

       6 degree taper cobalt chrome femoral heads

       Versys 12/14 cobalt chrome femoral heads

       Durasul polyethylene liners

       Epsilon Durasul constrained polyethylene inserts

       Longevity highly cross-linked polyethylene liners

00.75  Hip replacement bearing surface, metal-on-metal

Biomet (biomet.com)

       M2a – Magnum System

       M2a- Taper System

DePuy Orthopedics, Inc. (depuy.com)

       Ultamet Metal-on-Metal Articulation

Encore Medical (encoremed.com)

       Encore Large Metal/Metal

Wright Medical Technology (wmt.com)

       Conserve Total Hip System with BFH Technology

       Transcend Metal-on-Metal Articulation System

Zimmer (zimmer.com)

       Metasul Metal-on-Metal

00.76  Hip replacement bearing surface, ceramic-on-ceramic

CeramTec (ceramtec.com)

       Biolox delta ceramic femoral heads

       Biolox  forte ceramic femoral heads

       Biolox delta ceramic cup inserts

       Biolox forte ceramic cup inserts

Depuy Orthopedics, Inc. (depuy.com)

       Duraloc Option Ceramic Hip System (using CeramTec components)

Encore Medical (encoremed.com)

       Keramos Acetabular System (using alumina ceramic heads and liners)

Hayes Medical (hayesmed.com)

       Zirconia and alumina ceramic heads

Smith & Nephew (smith-nephew.com)

       Reflection Ceramic Acetabular System

Stryker (stryker.com)

       C-Taper alumina ceramic femoral heads

       V40 alumina ceramic femoral heads

       Trident Ceramic Acetabular System

Wright Medical Technology (wmt.com)

       Lineage alumina ceramic heads

       Lineage ceramic liners

       Transcend Ceramic Hip Articulation System

  

Effective October 1, 2006, code 00.77 has been added to capture ceramic-on-polyethylene bearing surface. The same brand name ceramic heads listed under 00.76 and the same brand name polyethylene liners listed under 00.74 would apply to this new code.  Smith & Nephew has developed a new hybrid femoral head component made of oxinium, a zirconium metal alloy base treated with oxygen to create a ceramic bearing surface of zirconium oxide.  The oxinium femoral head can be combined with the company's Reflection XLPE to provide another example of a ceramic-on-polyethylene bearing surface.

Coders should bear in mind that the above list is not intended to be exhaustive, but merely to serve as a general reference describing what bearing surfaces are currently available.  In addition to the manufacturers’ websites mentioned above, coders should regularly consult activejoints.com, a site that keeps track of the latest orthopedic components to receive FDA approval or to be involved in ongoing clinical trials.  Totaljoints.info is another valuable website featuring helpful discussions of joint replacement components and the relative benefits and drawbacks of each of the materials currently in use.