Question

Answer the following questions. Remember to use the format CPT-4 code-modifier; when a modifier applies to the scenario. (No spaces)

example: 27510-RT

Incorrect 0/4 pts Question 1 65 year old male with syncope and debility. He was found to have a heart rate of 40 with pauses the cardiologist recommended an insertion of a permanent pacemaker with insertion of a transvenous ventricular lead only. 33227 Incorrect Question 2 2/4 pts 89 year old female status post a MI was taken to the OR for a coronary bypass. After cardioplegia was induced, the patient she underwent 2 venous grafts the first one to the right coronary artery, the second to the left anterior descending, in addition she had one arterial graft to the circumflex. Please review the guidelines, both before code 33510 and before code 33517 thoroughly before working on this question, only one of the two codes should be listed first, the other is always second. 33510-RC 33518-LD

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Answer #1

1 Insertion or replacement of permanent pacemaker with transvenous electrodes,ventricular-33207

2 To report combined arterial-venous grafts it is necessary to report two codes.The appropriate arterial graft code

CABG with artery only ,1 graft-33533

The appropriate combined arterial-venous graft code

CABG using venous and arterial grafts,2vein grafts-33518.

This code series 33517-33523 can never be billed alone.These are addd-on codes to the arterial grafting codes,33533-33536.Therefore 33517-33523 are modifier -51 exempt

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