How To Use CPT Code 33206

CPT 33206 describes the insertion or replacement of a permanent pacemaker with transvenous electrode(s) in the right atrium. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 33206?

CPT 33206 is used to describe the procedure of inserting or replacing a permanent pacemaker with transvenous electrode(s) in the right atrium. This code specifically applies when the provider creates an incision at the selected site, inserts the electrode catheter through a vein, and guides it to the right atrium using imaging guidance. The provider then implants one or more leads and attaches them to the pulse generator, which is placed in a pocket created under the clavicle or below the ribcage under the abdominal muscles. The pacemaker is evaluated and programmed during the procedure.

2. Official Description

The official description of CPT code 33206 is: ‘Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial.’

3. Procedure

1. The provider prepares the patient and administers anesthesia.
2. An incision is made at the selected site.
3. The electrode catheter is inserted through a vein and guided to the right atrium using imaging guidance.
4. One or more leads are inserted and attached to the pulse generator.
5. The pulse generator is implanted into a pocket created under the clavicle or below the ribcage under the abdominal muscles.
6. The pacemaker is evaluated and programmed.

4. Qualifying circumstances

CPT 33206 is used for patients who require the insertion or replacement of a permanent pacemaker with transvenous electrode(s) in the right atrium. This procedure is typically performed on patients with specific cardiac conditions that necessitate the use of a pacemaker. The provider must follow the guidelines and criteria outlined in the official description of the code.

5. When to use CPT code 33206

CPT code 33206 should be used when the provider is performing the insertion or replacement of a permanent pacemaker with transvenous electrode(s) specifically in the right atrium. It is important to accurately document the procedure and ensure that it meets the criteria outlined in the official description of the code.

6. Documentation requirements

To support a claim for CPT code 33206, the provider must document the following information:

• Patient’s diagnosis and the need for the pacemaker insertion or replacement
• Specific details of the procedure, including the incision site, insertion of the electrode catheter, placement of leads, and implantation of the pulse generator
• Evaluation and programming of the pacemaker
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 33206, it is important to ensure that the procedure meets the criteria outlined in the official description. The provider should use the appropriate code based on the specific location of the electrode insertion or replacement. It is also important to follow any additional guidelines or tips provided by the payer or coding guidelines to ensure accurate billing.

8. Historical information

CPT code 33206 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A cardiologist performing the insertion of a permanent pacemaker with transvenous electrode(s) in the right atrium for a patient with bradycardia.
2. An electrophysiologist replacing a malfunctioning permanent pacemaker with transvenous electrode(s) in the right atrium for a patient with heart block.
3. A cardiac surgeon inserting a permanent pacemaker with transvenous electrode(s) in the right atrium during a bypass surgery for a patient with conduction system abnormalities.
4. An interventional cardiologist replacing an old permanent pacemaker with transvenous electrode(s) in the right atrium for a patient with atrial fibrillation.
5. A cardiac electrophysiologist performing the insertion of a permanent pacemaker with transvenous electrode(s) in the right atrium for a patient with sick sinus syndrome.
6. A cardiothoracic surgeon replacing a worn-out permanent pacemaker with transvenous electrode(s) in the right atrium for a patient with heart failure.
7. An interventional radiologist inserting a permanent pacemaker with transvenous electrode(s) in the right atrium for a patient with cardiac arrhythmias.
8. A cardiac electrophysiologist replacing a malfunctioning permanent pacemaker with transvenous electrode(s) in the right atrium for a patient with syncope.
9. A cardiothoracic surgeon performing the insertion of a permanent pacemaker with transvenous electrode(s) in the right atrium for a patient with cardiomyopathy.
10. An interventional radiologist replacing an old permanent pacemaker with transvenous electrode(s) in the right atrium for a patient with ventricular tachycardia.