Medicare Benefits Schedule - Item 90300

Professional attendance by a cardiothoracic surgeon in the practice of the surgeon’s speciality, if:

(a) the service is:

     (i) performed in conjunction with a service (the lead extraction service) to which item 38358 applies; or

     (ii) performed in conjunction with a service (the leadless pacemaker extraction service) to which item 38373 or 38374 applies; and

(b) the surgeon:

     (i) is providing surgical backup for the provider (who is not a cardiothoracic surgeon) who is performing the lead extraction service or the leadless pacemaker extraction service; and

     (ii) is present for the duration of the lead extraction service or the leadless pacemaker extraction service, other than during the low risk pre and post extraction phases; and

     (iii) is able to immediately scrub in and perform a thoracotomy if major complications occur

(H)

Fee: $947.00 Benefit: 75% = $710.25

(See para TN.8.214 of explanatory notes to this Category)

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International guidelines state that delays from injury to open access to the heart of more than 5–10 minutes are often associated with a fatal outcome. Preparations for this procedure should provide for this rare but life threatening circumstance.

Claiming guide:

When the service to which item 38358 applies is provided to a patient by an accredited interventional cardiologist the following claiming will apply:

• Item 38358 is to be claimed by the accredited interventional cardiologist; and
• Item 90300 is to be claimed by the standby cardiothoracic surgeon.

When the service to which item 38358 applies is provided to a patient by an accredited cardiothoracic surgeon the following claiming will apply:

• Item 38358 is to be claimed by the accredited cardiothoracic surgeon only

Related Items: 38358 90300