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Modifier - as the name implies a modifier will modify a service / procedure or an item under certain circumstances for appropriate reimbur...

Holding of claims containing procedure codes 33249 and C1882


The procedure-to-device edit files included in the January 2012 (V13.0) and April 2012 (V13.1) integrated outpatient code editor (I/OCE) do not allow the device described by the Healthcare Common Procedure Coding System (HCPCS) code C1882 (Cardioverter-defibrillator, other than single or dual chamber (implantable)) to satisfy the edit in place for CPT code 33249 (Insertion or replacement of permanent pacing cardioverter-defibrillator system with transvenous lead(s), single or dual chamber).

The July 2012 I/OCE (V13.2) will be updated with a new procedure-to-device edit file that will allow HCPCS code C1882 to be billed with CPT code 33249. Medicare contractors will hold claims with dates of service between Sunday, January 1, 2012, and Saturday, June 30, 2012, for the device described by HCPCS code C1882 when used in conjunction with the procedure described by CPT code 33249, until V13.2 of the I/OCE is installed by contractors on Monday, July 2, 2012, so these claims may be processed for payment.
 

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