How To Use CPT Code 33223

CPT 33223 describes the relocation of a skin pocket for an 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 33223?

CPT 33223 is used to describe the procedure of relocating the skin pocket for an implantable defibrillator. This code is used when the provider creates a new pocket in a different location and moves the defibrillator device pocket in a patient who already has an implantable defibrillator. The procedure is typically performed due to complications such as infection or erosion at the original site.

2. Official Description

The official description of CPT code 33223 is: ‘Relocation of skin pocket for implantable defibrillator.’

3. Procedure

1. The provider begins by making an incision over the scar from the original impulse generator placement.
2. Any scar tissue found around the device and leads is removed, and the site is inspected.
3. An alternate location for the implantable defibrillator is chosen, and an incision is made in the subcutaneous tissue to create a new pocket for the device.
4. The leads are disconnected from the device, and the electrodes are passed to the new pocket, creating a new subcutaneous tunnel if necessary.
5. The device is placed in the new pocket, the electrodes are attached, and the device is tested.
6. The provider then sutures the pocket closed and addresses the old pocket to prevent infection and ensure healing.
7. The wound is closed in layers to complete the procedure.

4. Qualifying circumstances

CPT 33223 is performed when there is a need to relocate the skin pocket for an implantable defibrillator due to complications such as infection or erosion at the original site. It is important to note that CPT 33223 should not be reported in conjunction with codes 10140, 10180, 11042, 11043, 11044, 11045, 11046, 11047, 13100, 13101, or 13102.

5. When to use CPT code 33223

CPT code 33223 should be used when the provider performs the procedure to relocate the skin pocket for an implantable defibrillator. It is important to ensure that the procedure is necessary due to complications at the original site. This code should not be used in conjunction with certain other codes, as mentioned in the qualifying circumstances section.

6. Documentation requirements

To support a claim for CPT 33223, the provider must document the following information:

• Reason for the relocation of the skin pocket
• Details of the procedure, including the incision, removal of scar tissue, creation of a new pocket, and attachment of electrodes
• Any complications encountered during the procedure
• Steps taken to prevent infection and ensure healing of the old pocket
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 33223, ensure that the procedure involves the relocation of the skin pocket for an implantable defibrillator. It is important to note that CPT 33223 should not be reported with certain other codes, as mentioned in the qualifying circumstances section. It is also recommended to use modifier TC when reporting this code. Additional tips for accurate billing can be obtained from the payer or coding guidelines.

8. Historical information

CPT 33223 was added to the Current Procedural Terminology system on January 1, 1994. There have been several code changes and revisions since its addition, with the most recent change occurring on January 1, 2015, when the description was updated to specify the relocation of the skin pocket for a cardioverter-defibrillator.

9. Examples

1. A provider performs the relocation of a skin pocket for an implantable defibrillator in a patient who developed an infection at the original site.
2. Due to erosion at the original site, a provider performs the procedure to relocate the skin pocket for an implantable defibrillator in a patient.
3. A patient experiences complications from the implantable defibrillator at the original site, leading to the need for the relocation of the skin pocket by a provider.
4. After careful evaluation, a provider determines that the relocation of the skin pocket for an implantable defibrillator is necessary in a patient due to infection.
5. A provider performs the procedure to relocate the skin pocket for an implantable defibrillator in a patient who experienced erosion at the original site.
6. Due to complications, a provider decides to relocate the skin pocket for an implantable defibrillator in a patient.
7. A patient develops an infection at the original site of the implantable defibrillator, leading to the need for the relocation of the skin pocket by a provider.
8. After careful assessment, a provider determines that the relocation of the skin pocket for an implantable defibrillator is necessary in a patient due to erosion.
9. A provider performs the procedure to relocate the skin pocket for an implantable defibrillator in a patient who experienced complications at the original site.
10. Due to infection at the original site, a provider decides to relocate the skin pocket for an implantable defibrillator in a patient.