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Is a pacemaker placement considered a major enough surgery to use the “aftercare following surgery on the circulatory system” code?  

It would generally be acceptable to use the aftercare code for pacemaker placement as an additional active diagnosis, as long as care is being provided related to the surgery; However, pacemaker placement would likely not typically be considered major enough to meet the RAI definition of major surgery for coding in section J of the MDS or for being the primary reason for skilled care. Of course, the clinical circumstances of the resident must be considered.

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Blog by Shelly Maffia, MSN, MBA, RN, LNHA, QCP, CHC, Director of Regulatory Services, Proactive Medical Review

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