Q&A: ICD-10-PCS reporting for CRT-Ps

Q: We are having trouble with a case that involves an Implantation of a cardiac resynchronization therapy-pacemaker (CRT-P) with three leads and an envelope since our facility is new to using pacemaker envelopes. How should this procedure be reported in ICD-10-PCS?

A: Some physicians will opt to place the pacemaker generator into an absorbable, antibiotic envelope to help prevent infection. This part alone can be tricky since there are also ICD-10-PCS codes for the Introduction of an anti-infective envelope.

So, for example, a typical implantation of a CRT-P with its three leads and use of an anti-infective envelope would require the following five ICD-10-PCS codes:

• 0JH607Z, Insertion of cardiac resynchronization pacemaker pulse generator into chest subcutaneous tissue and fascia, open approach
• 02H43JZ, Insertion of pacemaker lead into coronary vein, percutaneous approach
• 02H63JZ, Insertion of pacemaker lead into right atrium, percutaneous approach
• 02HK3JZ, Insertion of pacemaker lead into right ventricle, percutaneous approach
• 3E0102A, Introduction of anti-infective envelope into subcutaneous tissue, open approach

Editor’s note: Sarah A. Nehring, CCS, CCDS, RHIT, lead inpatient coding educator at a large teaching hospital in central Illinois, answered this question. Contact her at nehrings4@gmail.com.

This answer was provided based on limited information. Be sure to review all documentation specific to your own individual scenario before determining appropriate code assignment.