How To Use CPT Code 33237

CPT 33237 describes the removal of a permanent epicardial pacemaker and electrodes by thoracotomy, specifically for a dual lead system. 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 33237?

CPT 33237 can be used to describe the surgical procedure performed by a healthcare provider to remove a permanent epicardial pacemaker and electrodes through a thoracotomy. This code specifically applies to cases where a dual lead system is being removed. The pacemaker system consists of a pacemaker generator, which is a small battery-powered device, and lead wires that connect the heart muscle to the pacemaker generator.

2. Official Description

The official description of CPT code 33237 is: ‘Removal of permanent epicardial pacemaker and electrodes by thoracotomy; dual lead system.’

3. Procedure

1. The healthcare provider prepares the patient for the procedure, ensuring they are appropriately prepped and anesthetized.
2. An incision is made in the chest wall, allowing the provider to access a small area of the heart where the electrodes are attached.
3. The provider removes any scar tissue surrounding the leads and electrode attachments to the heart’s surface.
4. The electrodes are then separated from the heart, and any defects resulting from their removal are repaired.
5. The provider proceeds to address the pacemaker generator, which is located just under the skin in the chest wall.
6. An incision is made along the scar from the previous placement procedure, exposing the generator.
7. The generator is disconnected from the electrode leads and removed.
8. The cardiac device pocket is closed, and any bleeding at the surgical site is stopped.
9. The chest wall wound is closed by suturing the tissues in layers.

4. Qualifying circumstances

CPT 33237 is applicable when a healthcare provider performs a thoracotomy to remove a permanent epicardial pacemaker and electrodes. This code specifically applies to cases involving a dual lead system. It is important to note that this procedure should only be reported when both lead electrodes and the pacemaker are being removed.

5. When to use CPT code 33237

CPT code 33237 should be used when a healthcare provider performs a thoracotomy to remove a permanent epicardial pacemaker and electrodes in a case involving a dual lead system. It is important to ensure that all components of the pacemaker system are being removed to accurately report this code.

6. Documentation requirements

To support a claim for CPT 33237, the healthcare provider must document the following information:

• Patient’s medical history and indication for pacemaker removal
• Details of the thoracotomy procedure, including the incision site and approach
• Description of the removal of the pacemaker and electrodes
• Repair of any defects resulting from electrode removal
• Closure of the cardiac device pocket
• Method used to stop bleeding at the surgical site
• Details of the closure of the chest wall wound
• Any complications or additional procedures performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 33237, ensure that the procedure involves the removal of a permanent epicardial pacemaker and electrodes through a thoracotomy. It is important to accurately document the details of the procedure and any additional services provided. There are no specific guidelines regarding reporting CPT 33237 with other codes, but it is essential to follow any applicable payer guidelines and modifiers if necessary.

8. Historical information

CPT 33237 was added to the Current Procedural Terminology system on January 1, 1994. The code has not undergone any updates since its addition. It is important to stay updated with any changes or revisions to ensure accurate reporting.

9. Examples

1. A healthcare provider performs a thoracotomy to remove a permanent epicardial pacemaker and electrodes from a patient with a dual lead system.
2. During the procedure, the provider repairs any defects resulting from the removal of the electrodes and closes the cardiac device pocket.
3. The chest wall wound is then closed, and the patient recovers without any complications.
4. In another case, a healthcare provider performs a thoracotomy to remove a permanent epicardial pacemaker and electrodes from a patient with a dual lead system.
5. The provider also performs a revision of the pocket to ensure proper closure.
6. The chest wall wound is closed, and the patient’s recovery is uneventful.
7. These examples demonstrate the use of CPT code 33237 in cases involving the removal of a permanent epicardial pacemaker and electrodes through a thoracotomy for a dual lead system.