Question

For the following, what CPT codes would be used to report the each scenario? (if you don't know the correct CPT codes, please do not attempt to answer the question thank you!)

1. A single physician inserts both a permanent pacemaker pulse generator and epicardial electrodes in the right atrium and right ventricle by thoracotomy (during the same surgical session). How should this service be reported?
2. A physician replaces a two-year-old permanent pacemaker system consisting of a pulse generator and a single transvenous electrode placed in the right atrium (both the pulse generator and electrode were replaced). The new electrode is placed back into the right atrium transvenously. The procedure required revision of the skin pocket to hold the pulse generator and insertion of the new pulse generator. How should these services be reported?   
3. Four months after the insertion of a permanent pacemaker and the placement of an electrode in the right ventricle, the same physician repositions the electrode transvenously. How should this repositioning be reported?

Answer 1

A1) 33202-insertion of epidural electrodes (thoracotomy)

33212-insertion of pacemaker pulse generator only with exiting single electrode.

33213-insertion of pacemaker pulse generator only with existing dual lead.

33221-insertion of pacemaker pulse generator only with existing multiple leads.

this can be reported as 33202 in conjunction with 33212,33213,33221.

A2)The procedure can be reported as 33206 in conjuction with 33222

A3)This can be reported as 33212 in conjunction with 33226,33207.