Payment can be made for the insertion and removal of an intra-aortic balloon pump (codes 33967, 33968, 33970, 33971).

Monitoring of an intra-aortic balloon pump is considered an integral part of medical care. It is not eligible as a distinct and separate service when performed with medical services. If monitoring of an intra-aortic balloon pump is reported on the same day as medical care, and the charges are itemized, combine the charges and pay only the medical care. Payment for the medical care performed on the same date of service includes the allowance for the monitoring. A participating, preferred, or network provider cannot bill the member separately for the monitoring in this case.

If the monitoring of an intra-aortic balloon pump is performed independently, process it under procedure code 33999.

Modifier 25 may be reported with medical care to identify it as a significant, separately identifiable service from the monitoring of an intra-aortic balloon pump. When the 25 modifier is reported, the patient’s records must clearly document that separately identifiable medical care has been rendered.

Description

An intra-aortic balloon pump is a device usually inserted via cut-down in the area of the groin to aid patients in cardiogenic shock, for unrelenting angina pectoris which is not controlled by usual medical therapy, or in surgical preparation and management of a poor risk cardiac patient. The balloon is usually left in place from two to fourteen days before it is removed.