How To Use CPT Code 33235

CPT 33235 describes the removal of transvenous pacemaker electrode(s) in a dual lead system. 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 33235?

CPT 33235 is used to describe the procedure of removing two electrode leads from a transvenous pacemaker in a dual lead system. This code is specifically for cases where the provider makes an incision to open the pacemaker pocket and disconnects and removes the leads from the generator.

2. Official Description

The official description of CPT code 33235 is the “Removal of transvenous pacemaker electrode(s); dual lead system.” This code is used when the provider removes two electrode leads from the pacemaker generator.

3. Procedure

1. The provider prepares the patient and administers anesthesia.
2. An incision is made to open the cardiac device pocket.
3. The provider disconnects two electrode leads from the generator.
4. The provider dissects the electrode leads from the scar tissue around their length, down to their entry point in the vein.
5. The provider frees the leads from the scar tissue and twists them counter clockwise to extract them.
6. If necessary, the provider sutures the vein to control bleeding.
7. The provider closes the cardiac device pocket.

4. Qualifying circumstances

CPT 33235 is performed when a patient has a transvenous pacemaker with a dual lead system and requires the removal of two electrode leads. The procedure is typically done when the leads need to be replaced, the pacemaker is no longer needed, or there are complications with the leads.

5. When to use CPT code 33235

CPT code 33235 should be used when a provider is removing two electrode leads from a transvenous pacemaker in a dual lead system. It should not be used for the removal of a single lead or for other types of pacemaker systems.

6. Documentation requirements

To support a claim for CPT 33235, the provider must document the following information:

• Patient’s diagnosis and the reason for lead removal
• Details of the procedure, including the incision, disconnection of leads, and extraction process
• Any complications encountered during the procedure
• Any additional procedures performed during the same session
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 33235, ensure that the procedure involves the removal of two electrode leads in a dual lead system. It should not be reported with other codes for the removal of single leads or different types of pacemaker systems. It is important to follow the specific guidelines provided by the payer to ensure accurate billing and reimbursement.

8. Historical information

CPT 33235 was added to the Current Procedural Terminology system on January 1, 1994. There have been no updates or changes to the code since its addition.

9. Examples

1. A cardiologist removes two electrode leads from a patient’s transvenous pacemaker in a dual lead system.
2. An electrophysiologist performs the removal of two electrode leads from a patient’s pacemaker due to lead malfunction.
3. A cardiac surgeon removes two electrode leads from a patient’s pacemaker during a scheduled replacement procedure.
4. An interventional cardiologist removes two electrode leads from a patient’s pacemaker due to infection.
5. A cardiac nurse assists a provider in the removal of two electrode leads from a patient’s pacemaker during a follow-up visit.
6. A cardiac technician documents the removal of two electrode leads from a patient’s pacemaker in the medical record.
7. A healthcare administrator ensures that the appropriate CPT code, 33235, is used for the removal of two electrode leads from a patient’s pacemaker.
8. A medical coder reviews the documentation and assigns CPT code 33235 for the removal of two electrode leads from a patient’s pacemaker.
9. A billing specialist submits a claim with CPT code 33235 for the removal of two electrode leads from a patient’s pacemaker.
10. A reimbursement analyst verifies the accuracy of the billed charges for CPT code 33235 for the removal of two electrode leads from a patient’s pacemaker.