How To Use CPT Code 33222

CPT 33222 describes the relocation of a skin pocket for a pacemaker. 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 33222?

CPT 33222 can be used to describe the procedure of creating a new pocket for a pacemaker in a different location and relocating the pacemaker. This code is used when the physician cuts away scar tissue, tests the leads, and inspects the site and pacer. The physician then makes an incision in the subcutaneous tissue to create a new pocket for the pacemaker. The leads and pacer are connected and placed in the new pocket, which is then closed. The old pocket is addressed to prevent infection and ensure healing.

2. Official Description

The official description of CPT code 33222 is: ‘Relocation of skin pocket for pacemaker.’

3. Procedure

1. The physician preps the sites of the existing and planned pockets.
2. The patient may be sedated and local anesthesia administered.
3. ECG, blood pressure, and pulse oximetry are monitored.
4. The physician cuts any scar tissue away from the pacer and leads.
5. The leads are tested, and the site and pacer are inspected.
6. The physician makes an incision in the subcutaneous tissue to create a new pocket for the pacer.
7. Additional anesthesia may be administered to allow the physician to place lead extenders to the new pocket.
8. The leads and pacer are connected and placed in the new pocket, which is closed.
9. The old pocket is addressed to prevent infection and ensure healing.

4. Qualifying circumstances

Patients eligible for CPT 33222 are those who require the relocation of a pacemaker pocket due to erosion or the pocket being too small. This procedure is performed by a physician and involves creating a new pocket in a different location for the pacemaker.

5. When to use CPT code 33222

CPT code 33222 should be used when a physician performs the relocation of a pacemaker pocket by creating a new pocket in a different location. This code should not be reported in conjunction with codes 10140, 10180, 11042, 11043, 11044, 11045, 11046, 11047, 13100, 13101, or 13102.

6. Documentation requirements

To support a claim for CPT 33222, the physician must document the following information:

• Reason for the relocation of the pacemaker pocket
• Preparation of the existing and planned pocket sites
• Details of any sedation or anesthesia administered
• Monitoring of ECG, blood pressure, and pulse oximetry
• Description of the procedure, including cutting scar tissue, testing leads, and inspecting the site and pacer
• Creation of a new pocket in the subcutaneous tissue
• Placement of lead extenders, if applicable
• Connection of leads and placement of the pacer in the new pocket
• Closure of the new pocket and addressing of the old pocket
• Signature of the performing physician

7. Billing guidelines

When billing for CPT 33222, ensure that the procedure is performed by a physician and involves the relocation of a pacemaker pocket. Do not report CPT 33222 in conjunction with codes 10140, 10180, 11042, 11043, 11044, 11045, 11046, 11047, 13100, 13101, or 13102.

8. Historical information

CPT 33222 was added to the Current Procedural Terminology system on January 1, 1990. The code was revised on January 1, 2014 to specify the relocation of a skin pocket for a pacemaker.

9. Examples

1. A physician creates a new pocket in the upper abdominal wall and relocates a pacemaker for a patient with erosion of the existing pocket.
2. A physician performs the relocation of a pacemaker pocket by creating a new pocket in the chest for a patient with a pocket that is too small.
3. A physician cuts away scar tissue, tests the leads, and inspects the site and pacer before creating a new pocket for a pacemaker in the subcutaneous tissue.
4. A physician places lead extenders to a new pocket and connects the leads and pacer for a patient requiring the relocation of a pacemaker pocket.
5. A physician addresses the old pocket to prevent infection and ensure healing after relocating a pacemaker to a new pocket in the upper abdominal wall.
6. A physician performs the relocation of a pacemaker pocket by creating a new pocket in the chest for a patient with erosion of the existing pocket.
7. A physician cuts away scar tissue, tests the leads, and inspects the site and pacer before creating a new pocket for a pacemaker in the subcutaneous tissue.
8. A physician places lead extenders to a new pocket and connects the leads and pacer for a patient requiring the relocation of a pacemaker pocket.
9. A physician addresses the old pocket to prevent infection and ensure healing after relocating a pacemaker to a new pocket in the upper abdominal wall.
10. A physician performs the relocation of a pacemaker pocket by creating a new pocket in the chest for a patient with a pocket that is too small.