Medicare Benefits Schedule - Note TN.8.214

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Category 3 - THERAPEUTIC PROCEDURES

TN.8.214

International guidelines and claiming guide for extraction of leads

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


Related Items

Category 3 - THERAPEUTIC PROCEDURES

38358

38358 - Additional Information

Item Start Date:
01-Nov-2005
Description Updated:
01-Jul-2021
Schedule Fee Updated:
01-Nov-2023

Extraction of one or more chronically implanted transvenous pacing or defibrillator leads, by percutaneous method, with locking stylets and snares, with extraction sheaths (if any), if:

(a) the leads have been in place for more than 6 months and require removal; and

(b) the service is performed:

(i) in association with a service to which item 61109 or 60509 applies; and

(ii) by a specialist or consultant physician who has undertaken the training to perform the service; and

(iii) in a facility where cardiothoracic surgery is available and a thoracotomy can be performed immediately and without transfer; and

(c) if the service is performed by an interventional cardiologist—a cardiothoracic surgeon is in attendance during the service

(H) 

(Anaes.) (Assist.)

Fee: $3,156.85 Benefit: 75% = $2,367.65

(See para TN.8.64, TN.8.214 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

90300

90300 - Additional Information

Item Start Date:
01-Jul-2021
Description Updated:
01-Nov-2023
Schedule Fee Updated:
01-Nov-2023

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)


Legend

  • Assist - Addition/Deletion of (Assist.)
  • Amend - Amended Description
  • Anaes - Anaesthetic Values Amended
  • Emsn - EMSN Change
  • Fee - Fee Amended
  • Renum - Item Number Change (renumbered)
  • New - New Item
  • NewMin - New Item (previous Ministerial Determination)
  • Qfe - QFE Change