How To Use CPT Code 33262

CPT 33262 describes the procedure for the removal and replacement of an implantable defibrillator pulse generator with a single lead system. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 33262?

CPT 33262 can be used to describe the removal and replacement of an implantable defibrillator pulse generator with a single lead system. This code is used when the provider removes the existing generator and replaces it with a new one for a patient with a lead to a single chamber of the heart. Implantable defibrillators are devices that sense and regulate the heart rate by delivering a mild electric shock when necessary. The removal and replacement of components may be necessary when they no longer function properly or when an infection occurs.

2. Official Description

The official description of CPT code 33262 is: ‘Removal of implantable defibrillator pulse generator with replacement of implantable defibrillator pulse generator; single lead system.’

3. Procedure

1. The provider prepares the patient for the procedure, ensuring appropriate anesthesia and sterilization.
2. An incision is made on the skin of the subcutaneous pocket enclosing the existing generator.
3. The existing generator is freed from the fibrous adhesions surrounding it, and the lead is separated from the fibrous adhesions in the pocket.
4. The existing lead is tested for proper functioning.
5. If needed, the existing skin pocket is adapted to the dimensions of the new single lead system generator.
6. The pocket is cleaned by irrigating it with saline.
7. The new generator is placed into the pocket and the existing lead is attached to it.
8. The skin pocket is closed with sutures, staples, or tissue adhesive.
9. The provider programs the device for proper functioning.

4. Qualifying circumstances

CPT 33262 is performed for patients who require the removal and replacement of an implantable defibrillator pulse generator with a single lead system. The procedure is typically done when the existing generator is no longer functioning properly or when an infection occurs. The patient must have a lead to a single chamber of the heart. Adhesions, which are fibrous bands that form between tissues and organs, may be present and need to be addressed during the procedure.

5. When to use CPT code 33262

CPT code 33262 should be used when the provider performs the complete procedure of removing and replacing an implantable defibrillator pulse generator with a single lead system. This code is specific to single lead systems, meaning the implantable defibrillator functions in only one cardiac chamber. It should not be reported in conjunction with codes 33271, 93260, 93261, or 0614T. For the removal and replacement of a substernal implantable pulse generator, a different code, 0614T, should be used.

6. Documentation requirements

To support a claim for CPT 33262, the provider must document the following information:

• Patient’s diagnosis and the need for removal and replacement of the implantable defibrillator pulse generator
• Details of the procedure, including the incision, removal of the existing generator, separation of the lead, testing of the existing lead, adaptation of the skin pocket, cleaning of the pocket, placement of the new generator, attachment of the existing lead, closure of the skin pocket, and programming of the device
• Any complications or adhesions encountered during the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 33262, ensure that the procedure involves the removal and replacement of an implantable defibrillator pulse generator with a single lead system. It should not be reported with codes 33271, 93260, 93261, or 0614T. It is important to follow the specific guidelines and tips provided by the payer to ensure accurate and appropriate billing.

8. Historical information

CPT 33262 was added to the Current Procedural Terminology system on January 1, 2012. There have been no updates to the code since its addition. Prior to 2012, there was no specific code for the removal and replacement of an implantable defibrillator pulse generator with a single lead system.

9. Examples

1. A cardiologist performs the removal and replacement of an implantable defibrillator pulse generator with a single lead system for a patient with a lead to the right ventricle.
2. An electrophysiologist removes and replaces an implantable defibrillator pulse generator with a single lead system for a patient with a lead to the right atrium.
3. A cardiac surgeon performs the removal and replacement of an implantable defibrillator pulse generator with a single lead system for a patient with a lead to the left ventricle.
4. An interventional cardiologist removes and replaces an implantable defibrillator pulse generator with a single lead system for a patient with a lead to the left atrium.
5. A cardiac electrophysiologist performs the removal and replacement of an implantable defibrillator pulse generator with a single lead system for a patient with a lead to the right ventricle.
6. A cardiothoracic surgeon removes and replaces an implantable defibrillator pulse generator with a single lead system for a patient with a lead to the right atrium.