How To Use CPT Code 33233

CPT 33233 describes the removal of a permanent pacemaker pulse generator by a healthcare provider. 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 33233?

CPT 33233 is used to describe the procedure of removing a permanent pacemaker pulse generator by a healthcare provider. This code specifically refers to the removal of the pulse generator only, without replacing it or removing and replacing the generator and leads. It is important to note that this code does not include the removal of the pacemaker electrodes.

2. Official Description

The official description of CPT code 33233 is: ‘Removal of permanent pacemaker pulse generator only.’

3. Procedure

1. The healthcare provider prepares the patient for the procedure, ensuring they are appropriately prepped and anesthetized.
2. The provider makes an incision in the skin to access the pacemaker pocket.
3. Once the pocket is open, the provider disconnects the pulse generator from the wires and leads.
4. The provider removes the pulse generator from the pocket, leaving the wires in place.
5. Finally, the provider closes the cardiac device pocket.

4. Qualifying circumstances

CPT 33233 is performed when a patient has a permanent pacemaker pulse generator that needs to be removed. This procedure may be necessary due to various reasons, such as device malfunction, infection, or the need for an upgrade or replacement. It is important to note that this code does not include the removal of the pacemaker electrodes.

5. When to use CPT code 33233

CPT code 33233 should be used when a healthcare provider performs the removal of a permanent pacemaker pulse generator without replacing it or removing and replacing the generator and leads. If the provider performs additional procedures, such as replacing the pulse generator or inserting a new generator with existing leads, different codes should be used.

6. Documentation requirements

To support a claim for CPT 33233, the healthcare provider must document the following information:

• Reason for the removal of the permanent pacemaker pulse generator
• Date of the procedure
• Details of the procedure, including the incision, disconnection of the pulse generator, removal of the generator, and closure of the pocket
• Any complications or additional procedures performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 33233, ensure that the procedure performed is the removal of the permanent pacemaker pulse generator only. This code should not be reported if the provider also performs the removal and replacement of the generator or the removal and replacement of the generator and leads. It is important to review the documentation and accurately report the services provided.

8. Historical information

CPT 33233 was added to the Current Procedural Terminology system on January 1, 1994, as a code for the removal of a permanent pacemaker pulse generator. There have been no updates or changes to the code since its addition.

9. Examples

1. A cardiologist removes a malfunctioning permanent pacemaker pulse generator from a patient’s chest.
2. A cardiac surgeon performs the removal of a permanent pacemaker pulse generator due to an infection.
3. An electrophysiologist removes a pacemaker pulse generator as part of an upgrade to a newer model.
4. A healthcare provider removes a permanent pacemaker pulse generator from a patient who no longer requires it.
5. A cardiac nurse assists a physician in the removal of a permanent pacemaker pulse generator during a procedure.
6. A cardiovascular technologist prepares the patient for the removal of a permanent pacemaker pulse generator and ensures proper sterilization of the equipment.
7. A cardiac anesthesiologist administers anesthesia to a patient undergoing the removal of a permanent pacemaker pulse generator.
8. A cardiac nurse documents the details of the removal of a permanent pacemaker pulse generator in the patient’s medical record.
9. A healthcare administrator ensures that the appropriate billing codes are used for the removal of a permanent pacemaker pulse generator.
10. A medical coder reviews the documentation and assigns the correct CPT code for the removal of a permanent pacemaker pulse generator.