How To Use CPT Code 33234

CPT 33234 describes the removal of a single atrial or ventricular electrode lead from a transvenous 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 33234?

CPT 33234 is used to describe the removal of a single atrial or ventricular electrode lead from a transvenous pacemaker. This procedure involves making an incision to open the pacemaker pocket and disconnecting and removing the electrode lead.

2. Official Description

The official description of CPT code 33234 is: ‘Removal of transvenous pacemaker electrode(s); single lead system, atrial or ventricular.’

3. Procedure

1. The provider prepares the patient and administers anesthesia.
2. An incision is made to open the pacemaker pocket.
3. The provider disconnects the transvenous electrode lead from the generator.
4. The electrode lead is dissected from the scar tissue around its length, down to its entry point in the vein.
5. The provider frees the lead from the scar tissue and twists it counter clockwise to extract it.
6. If necessary, the provider sutures the vein to control bleeding.
7. The pacemaker pocket is closed.

4. Qualifying circumstances

CPT 33234 is performed when a patient has a transvenous pacemaker with a single atrial or ventricular electrode lead that needs to be removed. The procedure is typically done by a provider who is experienced in cardiac device management. The patient must meet the criteria for pacemaker removal, and the provider must document the medical necessity for the procedure.

5. When to use CPT code 33234

CPT code 33234 should be used when a provider performs the removal of a single atrial or ventricular electrode lead from a transvenous pacemaker. It is important to ensure that the documentation supports the medical necessity for the procedure and that the patient meets the criteria for pacemaker removal.

6. Documentation requirements

To support a claim for CPT 33234, the provider must document the following information:

• Medical necessity for the pacemaker lead removal
• Details of the procedure, including the incision, disconnection of the lead, dissection from scar tissue, extraction, and closure of the pacemaker pocket
• Any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 33234, ensure that the documentation supports the medical necessity for the procedure and that the patient meets the criteria for pacemaker lead removal. It is important to follow the specific guidelines provided by the payer and to use the appropriate modifiers if necessary. Additionally, be aware of any bundling or unbundling issues that may affect the billing of CPT 33234.

8. Historical information

CPT 33234 was added to the Current Procedural Terminology system on January 1, 1994. There have been no updates to the code since its addition.

9. Examples

1. A provider removes a single atrial electrode lead from a transvenous pacemaker in a patient with a malfunctioning lead.
2. A patient with an infection at the pacemaker site requires the removal of a single ventricular electrode lead from their transvenous pacemaker.
3. A provider removes a single atrial electrode lead from a transvenous pacemaker in a patient who no longer requires the pacemaker.
4. A patient with a fractured electrode lead undergoes the removal of a single ventricular lead from their transvenous pacemaker.
5. A provider removes a single atrial electrode lead from a transvenous pacemaker in a patient who is upgrading to a dual lead system.
6. A patient with a pacemaker pocket infection requires the removal of a single ventricular electrode lead from their transvenous pacemaker.
7. A provider removes a single atrial electrode lead from a transvenous pacemaker in a patient who is transitioning to a different type of cardiac device.
8. A patient with a malfunctioning ventricular electrode lead undergoes the removal of a single ventricular lead from their transvenous pacemaker.
9. A provider removes a single atrial electrode lead from a transvenous pacemaker in a patient who is no longer dependent on the pacemaker.
10. A patient with a fractured electrode lead requires the removal of a single ventricular lead from their transvenous pacemaker.