How To Use CPT Code 33217

CPT 33217 describes the insertion of two transvenous electrodes 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 33217?

CPT 33217 can be used to describe the insertion of two transvenous electrodes for a permanent pacemaker or implantable defibrillator. This code is used when the provider inserts and attaches two electrodes transvenously to a previously implanted device.

2. Official Description

The official description of CPT code 33217 is: ‘Insertion of 2 transvenous electrodes, permanent pacemaker or implantable defibrillator.’

3. Procedure

1. The provider removes the cardiac pulse generator device and tests the electrode.
2. An electrode catheter is inserted through a vein, usually the subclavian or jugular veins, and guided to the appropriate cardiac chamber using imaging guidance if necessary.
3. The provider removes the defective electrode and passes a new lead over a guidewire through the catheter.
4. The new electrode is attached to the pulse generator already in place.
5. The procedure is repeated for the second defective electrode.
6. The function of the system is evaluated.

4. Qualifying circumstances

CPT 33217 is used when the patient already has a permanent pacemaker or implantable defibrillator in place and the electrodes need to be inserted or replaced. This procedure is performed when the device is not functioning properly due to a problem with the electrode.

5. When to use CPT code 33217

CPT code 33217 should be used when the provider inserts and attaches two transvenous electrodes to a previously implanted pacemaker or implantable defibrillator. It should not be reported in conjunction with other specific codes listed in the notes.

6. Documentation requirements

To support a claim for CPT 33217, the provider must document the following information:

• Reason for the procedure and the need for electrode insertion or replacement
• Specific details of the procedure, including the veins used for access and any imaging guidance used
• Description of the removal of the defective electrode and insertion of the new lead
• Evaluation of the system’s function after the procedure

7. Billing guidelines

When billing for CPT 33217, ensure that the procedure involves the insertion of two transvenous electrodes for a permanent pacemaker or implantable defibrillator. Do not report this code in conjunction with specific other codes listed in the notes. Follow any additional guidelines provided by the payer for accurate billing.

8. Historical information

CPT 33217 was added to the Current Procedural Terminology system on January 1, 1994. There have been several code changes since its addition, including updates to the description and the addition of notes regarding reporting with other codes.

9. Examples

1. A provider inserts two transvenous electrodes for a permanent pacemaker in a patient with bradycardia.
2. An implantable defibrillator already in place requires the insertion of two new transvenous electrodes due to malfunction.
3. A patient with a previously implanted pacemaker needs the replacement of two defective transvenous electrodes.
4. Two transvenous electrodes are inserted for a dual chamber pacing cardioverter-defibrillator in a patient with a history of ventricular arrhythmias.
5. A provider performs the insertion of two transvenous electrodes for a permanent pacemaker in a patient with heart block.
6. Two transvenous electrodes are inserted for an implantable defibrillator in a patient with a history of ventricular tachycardia.
7. A patient with a previously implanted pacemaker requires the replacement of two transvenous electrodes due to lead fracture.
8. Two new transvenous electrodes are inserted for a dual chamber pacing cardioverter-defibrillator in a patient with a history of atrial fibrillation.
9. An implantable defibrillator already in place needs the insertion of two transvenous electrodes due to lead dislodgement.
10. A provider performs the insertion of two transvenous electrodes for a permanent pacemaker in a patient with sick sinus syndrome.