How To Use CPT Code 33216

CPT 33216 describes the insertion of a single transvenous electrode for a permanent pacemaker or implantable defibrillator. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 33216?

CPT 33216 is used to describe the insertion of a single transvenous electrode for a permanent pacemaker or implantable defibrillator. This procedure is performed when the existing pacemaker or defibrillator is not functioning properly due to an issue with the electrode. The provider inserts the electrode through a vein, typically the subclavian or jugular veins, and connects it to the pulse generator already in place.

2. Official Description

The official description of CPT code 33216 is: ‘Insertion of a single transvenous electrode, permanent pacemaker or implantable defibrillator.’

3. Procedure

1. The provider prepares the patient and administers anesthesia.
2. The existing pacemaker or defibrillator device is removed.
3. The provider tests the electrode to ensure proper functioning.
4. An electrode catheter is inserted through a vein, guided by imaging if necessary, to the appropriate cardiac chamber.
5. A new lead is passed over a guidewire through the catheter.
6. The new electrode is attached to the pulse generator already in place.
7. The provider evaluates the function of the system.

4. Qualifying circumstances

CPT 33216 is performed when there is a problem with the electrode of a permanent pacemaker or implantable defibrillator. It is important to note that CPT 33216 should not be reported in conjunction with certain other codes, such as 33206, 33207, 33208, and others listed in the notes section.

5. When to use CPT code 33216

CPT code 33216 should be used when a provider inserts a single transvenous electrode for a permanent pacemaker or implantable defibrillator. It is important to ensure that the electrode is not functioning properly before performing this procedure.

6. Documentation requirements

To support a claim for CPT 33216, the provider must document the following information:

• Reason for the procedure and the need for electrode insertion
• Details of the procedure, including the specific veins used and any imaging guidance
• Description of the electrode testing and evaluation of system function
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 33216, ensure that the procedure meets the criteria for this code. It is important to note that CPT 33216 should not be reported with certain other codes listed in the notes section. Review the billing guidelines and notes carefully to ensure accurate reporting.

8. Historical information

CPT 33216 was added to the Current Procedural Terminology system on January 1, 1990. There have been several updates to the code since its addition, with the most recent update on January 1, 2015.

9. Examples

1. A cardiologist inserts a single transvenous electrode for a permanent pacemaker in a patient with bradycardia.
2. An electrophysiologist performs the insertion of a single transvenous electrode for an implantable defibrillator in a patient with a history of ventricular arrhythmias.
3. A cardiac surgeon replaces a malfunctioning electrode in a patient with an existing pacemaker.
4. An interventional cardiologist inserts a single transvenous electrode for a permanent pacemaker in a patient with heart block.
5. A cardiac electrophysiologist performs the insertion of a single transvenous electrode for an implantable defibrillator in a patient at high risk for sudden cardiac death.
6. A cardiothoracic surgeon replaces a faulty electrode in a patient with an existing implantable defibrillator.
7. An interventional radiologist inserts a single transvenous electrode for a permanent pacemaker in a patient with sick sinus syndrome.
8. A cardiac electrophysiologist performs the insertion of a single transvenous electrode for an implantable defibrillator in a patient with hypertrophic cardiomyopathy.
9. A cardiac surgeon replaces a malfunctioning electrode in a patient with an existing pacemaker.
10. An interventional cardiologist inserts a single transvenous electrode for a permanent pacemaker in a patient with complete heart block.