How To Use CPT Code 33230

CPT 33230 describes the insertion of an implantable defibrillator pulse generator with existing dual leads. 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 33230?

CPT 33230 is used to describe the procedure of inserting an implantable defibrillator pulse generator in a patient’s chest. This procedure is specifically performed when the patient already has dual leads in two chambers of the heart. The purpose of this procedure is to regulate the patient’s heart rate using the device, particularly for patients with arrhythmia, which is an irregular heart rhythm.

2. Official Description

The official description of CPT code 33230 is: ‘Insertion of implantable defibrillator pulse generator only; with existing dual leads.’

3. Procedure

1. The provider makes an incision in the subclavicular region, below the collarbone, and extends it to the subpectoral region in the front of the chest near the armpit.
2. A subcutaneous pocket is created in the pectoralis fascia or just below the pectoral muscle to place the new pulse generator for the dual lead system.
3. The existing leads are freed from fibrous adhesions and tested for proper functionality.
4. The leads are attached to the new pulse generator.
5. The provider closes the skin pocket using sutures, staples, or tissue adhesive.
6. The device is programmed for functionality.

4. Qualifying circumstances

CPT 33230 is performed on patients who already have dual leads in two chambers of the heart and require the insertion of an implantable defibrillator pulse generator. This procedure is primarily done for patients with arrhythmia, an irregular heart rhythm. The provider must ensure that the patient meets the specific criteria for this procedure.

5. When to use CPT code 33230

CPT code 33230 should be used when the provider is inserting an implantable defibrillator pulse generator with existing dual leads in a patient’s chest. It is important to accurately report this code when the procedure meets the specific requirements outlined in the official description.

6. Documentation requirements

To support a claim for CPT 33230, the provider must document the following information:

• Patient’s medical history and diagnosis
• Details of the procedure, including the incision site and creation of the subcutaneous pocket
• Testing and attachment of the existing leads to the new pulse generator
• Method of closure for the skin pocket
• Programming of the device for functionality

7. Billing guidelines

When billing for CPT 33230, ensure that the procedure meets the specific criteria outlined in the official description. It is important to accurately report this code and follow any additional guidelines provided by the payer. Additionally, consider any applicable modifiers or reporting requirements for this procedure.

8. Historical information

CPT 33230 was added to the Current Procedural Terminology system on January 1, 2012. There have been no updates or changes to the code since its addition.

9. Examples

1. A cardiologist performing the insertion of an implantable defibrillator pulse generator with existing dual leads for a patient with arrhythmia.
2. An electrophysiologist conducting the procedure to regulate the heart rate of a patient with dual leads in two chambers of the heart.
3. A cardiac surgeon performing the insertion of an implantable defibrillator pulse generator with existing dual leads for a patient with a history of arrhythmia.
4. An interventional cardiologist carrying out the procedure to ensure proper heart rate regulation in a patient with dual leads.
5. A cardiovascular specialist performing the insertion of an implantable defibrillator pulse generator with existing dual leads for a patient with a diagnosed irregular heart rhythm.
6. A cardiac electrophysiologist conducting the procedure to maintain the heart rate stability of a patient with dual leads in two chambers of the heart.
7. A cardiothoracic surgeon performing the insertion of an implantable defibrillator pulse generator with existing dual leads for a patient with a known arrhythmia condition.
8. An interventional radiologist carrying out the procedure to regulate the heart rate of a patient with dual leads in two chambers of the heart.
9. A cardiac electrophysiologist performing the insertion of an implantable defibrillator pulse generator with existing dual leads for a patient with a history of arrhythmia.
10. A cardiovascular specialist conducting the procedure to ensure proper heart rate regulation in a patient with dual leads.