Coding Dual-Chamber Leadless Pacemakers in ICD-10-PCS

Key Coding Considerations for Dual-Chamber Leadless Pacemaker Devices

Leadless pacemakers are no longer limited to single-chamber technology. Dual-chamber leadless pacemakers are now available and increasingly utilized, offering expanded pacing capabilities while maintaining the benefits of a leadless system.

From a clinical perspective, dual-chamber leadless pacemakers are designed to improve patient experience by reducing device-related complications, minimizing pocket-related infections, and eliminating lead-associated risks. These devices are also designed to be retrievable, which has contributed to broader adoption in appropriate patient populations.

Coding Considerations

When coding dual-chamber leadless pacemaker implantation procedures, several key factors must be considered.

First, dual-chamber leadless pacemakers are classified as new technology and must be coded accordingly within ICD-10-PCS. Coders should verify that the procedure meets new technology criteria as outlined in current guidance.



Second, unlike traditional single-device systems, dual-chamber leadless pacemakers involve the implantation of two separate devices, typically one placed in the right atrium and one in the right ventricle. Each device represents a distinct implantation and must be reported separately.

Accurate code assignment requires careful review of the operative report to identify:

• The specific cardiac chamber for each device
• The approach used for implantation
• The device type and new technology designation

Coding Clinic guidance and manufacturer resources provide clarification on the appropriate ICD-10-PCS tables and code selection for dual-chamber leadless pacemaker systems. Coders should reference these materials to ensure complete and compliant reporting.