How To Use CPT Code 33203

CPT 33203 describes the insertion of epicardial electrode(s) using an endoscopic approach, such as thoracoscopy or pericardioscopy. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 33203?

CPT 33203 involves the placement of one or more electrodes on the outer surface of the heart using an endoscopic approach, such as thoracoscopy or pericardioscopy. This procedure allows for the visualization and assessment of the epicardium and pericardium, which are the inner layers of the pericardium, the sac that surrounds the heart.

2. Official Description

The official description of CPT code 33203 is the insertion of epicardial electrode(s) using an endoscopic approach, such as thoracoscopy or pericardioscopy. It is important to note that when epicardial lead placement is performed along with the insertion of the generator, additional codes should be reported in conjunction with CPT 33203.

3. Procedure

1. During the procedure, the patient is appropriately prepped and anesthetized.
2. A small incision is made on the chest to access the pleural space.
3. The provider uses an endoscope, such as a thoracoscope, to guide the leads into the pleural space.
4. The leads are then attached to the pericardial surface.
5. Finally, the incision is closed, and the wound is dressed.

4. Qualifying circumstances

CPT 33203 is performed on patients who require the insertion of epicardial electrode(s) for diagnostic or therapeutic purposes. The procedure is typically indicated for patients with specific cardiac conditions that necessitate the visualization and assessment of the epicardium and pericardium. It is important to note that CPT 33203 should be reported in conjunction with other codes when the insertion of epicardial electrodes is performed along with the insertion of the generator.

5. When to use CPT code 33203

CPT code 33203 should be used when the provider performs the insertion of epicardial electrode(s) using an endoscopic approach, such as thoracoscopy or pericardioscopy. It is important to ensure that the documentation supports the use of an endoscopic approach and specifies the number of electrodes inserted.

6. Documentation requirements

To support a claim for CPT 33203, the provider must document the following information:

• Indication for the procedure and the need for epicardial electrode insertion
• Details of the endoscopic approach used, such as thoracoscopy or pericardioscopy
• Number of electrodes inserted
• Date of the procedure
• Start and end time of the procedure
• Any additional procedures performed in conjunction with CPT 33203
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 33203, it is important to ensure that the documentation supports the use of an endoscopic approach and specifies the number of electrodes inserted. Additionally, if the insertion of epicardial electrodes is performed along with the insertion of the generator, other codes should be reported in conjunction with CPT 33203. It is important to review payer-specific guidelines and modifiers, if applicable, to ensure accurate and appropriate billing.

8. Historical information

CPT 33203 was added to the Current Procedural Terminology system on January 1, 2007. Since its addition, there have been no updates or changes to the code. However, it is important to stay updated with any changes or revisions that may occur in the future.

9. Examples

1. A cardiologist performs an endoscopic procedure to insert epicardial electrodes for diagnostic purposes in a patient with suspected pericardial disease.
2. An electrophysiologist uses a thoracoscope to guide the insertion of epicardial electrodes for therapeutic purposes in a patient with refractory ventricular tachycardia.
3. A cardiac surgeon performs pericardioscopy to visualize the epicardium and pericardium and inserts epicardial electrodes for mapping purposes in a patient with atrial fibrillation.
4. An interventional cardiologist utilizes a pericardioscopy approach to insert epicardial electrodes for ablation purposes in a patient with ventricular arrhythmias.
5. A cardiothoracic surgeon performs thoracoscopy to guide the insertion of epicardial electrodes for biventricular pacing in a patient with heart failure.
6. A cardiac electrophysiologist uses an endoscopic approach to insert epicardial electrodes for cardiac resynchronization therapy in a patient with left bundle branch block.
7. A pediatric cardiologist performs pericardioscopy to visualize the epicardium and pericardium and inserts epicardial electrodes for diagnostic purposes in a child with congenital heart disease.
8. An interventional radiologist utilizes thoracoscopy to guide the insertion of epicardial electrodes for radiofrequency ablation in a patient with refractory ventricular tachycardia.
9. A cardiac surgeon performs pericardioscopy to visualize the epicardium and pericardium and inserts epicardial electrodes for epicardial pacing in a patient with complete heart block.
10. An electrophysiologist uses a thoracoscope to guide the insertion of epicardial electrodes for ablation purposes in a patient with atrial flutter.