How To Use CPT Code 33227

CPT 33227 describes the procedure of removing a previously placed pacemaker pulse generator and replacing it with a new one. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 33227?

CPT 33227 can be used to describe the removal of a permanent pacemaker pulse generator and the replacement with a new one. This procedure is primarily performed to regulate heartbeats in patients with arrhythmia, which is an irregular heart rhythm. It is specifically used for patients with a lead in a single chamber of the heart.

2. Official Description

The official description of CPT code 33227 is: ‘Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator; single lead system.’

3. Procedure

1. The provider prepares the patient for the procedure, ensuring appropriate anesthesia and sterilization.
2. An incision is made on the skin of the subcutaneous pocket containing the existing generator.
3. The existing generator is carefully freed from fibrous adhesions and the lead is separated from the pocket’s fibrous adhesions, taking care to protect the lead.
4. The functionality of the existing lead is tested.
5. If necessary, the existing skin pocket is adapted to fit the dimensions of the new generator.
6. The pocket is cleaned with saline irrigation.
7. The new generator for the single lead system is placed into the pocket and attached to the existing lead.
8. Hemostasis is achieved, and the skin pocket is closed with sutures, staples, or tissue adhesive.
9. The provider programs the device for functionality.

4. Qualifying circumstances

CPT 33227 is performed on patients who require the removal and replacement of a pacemaker pulse generator. The procedure is specifically for patients with a lead in a single chamber of the heart. It is typically performed to regulate heartbeats in patients with arrhythmia.

5. When to use CPT code 33227

CPT code 33227 should be used when a provider performs the removal of a permanent pacemaker pulse generator and replaces it with a new one. It is important to ensure that the procedure is specifically for a single lead system and that the patient meets the qualifying circumstances.

6. Documentation requirements

To support a claim for CPT 33227, the provider must document the following information:

• Patient’s diagnosis and the need for pacemaker pulse generator removal and replacement
• Details of the procedure, including the incision, removal of the existing generator, separation of the lead, testing of the existing lead, adaptation of the skin pocket, placement of the new generator, and closure of the pocket
• Date of the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 33227, ensure that the procedure involves the removal and replacement of a permanent pacemaker pulse generator for a single lead system. It is important to follow the specific guidelines for reporting this code and any associated radiological supervision and interpretation. Additionally, consider any tips provided for accurate reporting of CPT 33227.

8. Historical information

CPT 33227 was added to the Current Procedural Terminology system on January 1, 2012. There have been no updates to the code since its addition.

9. Examples

1. A cardiologist performs the removal and replacement of a pacemaker pulse generator for a patient with arrhythmia and a single lead system.
2. An electrophysiologist conducts the procedure to replace a malfunctioning pacemaker pulse generator in a patient with a single chamber lead.
3. A cardiac surgeon removes an old pacemaker pulse generator and replaces it with a new one for a patient with arrhythmia and a single lead system.
4. A cardiac nurse assists in the removal and replacement of a pacemaker pulse generator for a patient with a single chamber lead under the supervision of a cardiologist.
5. An interventional cardiologist performs the procedure to upgrade a pacemaker pulse generator in a patient with a single lead system.
6. A cardiac technician assists in the removal and replacement of a pacemaker pulse generator for a patient with arrhythmia and a single chamber lead.
7. A cardiovascular surgeon replaces a pacemaker pulse generator for a patient with a single lead system.
8. An electrophysiology technician assists in the removal and replacement of a pacemaker pulse generator for a patient with a single chamber lead.
9. A cardiac nurse practitioner performs the procedure to replace a pacemaker pulse generator in a patient with arrhythmia and a single lead system.
10. A cardiac surgeon upgrades a pacemaker pulse generator for a patient with a single lead system.