How To Use CPT Code 33263

CPT 33263 describes the procedure of removing and replacing an implantable defibrillator pulse generator with 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 33263?

CPT 33263 can be used to describe the removal and replacement of an implantable defibrillator pulse generator with a dual lead system. This code is used when the provider performs the procedure for a patient with leads to two chambers of the heart. Implantable defibrillators are devices that sense and regulate the heart rate by delivering a mild electric shock when necessary. The components of the device may need to be removed when they no longer function properly or when an infection occurs.

2. Official Description

The official description of CPT code 33263 is: ‘Removal of implantable defibrillator pulse generator with replacement of implantable defibrillator pulse generator; dual lead system.’

3. Procedure

1. The provider prepares the patient for the procedure and administers anesthesia.
2. An incision is made on the skin over the subcutaneous pocket containing the existing generator.
3. The provider frees the generator from the fibrous adhesions surrounding it and separates the leads from the fibrous adhesions in the pocket, ensuring the leads are protected from any damage.
4. The existing leads are tested for proper functioning.
5. If necessary, the provider adapts the existing skin pocket to accommodate the dimensions of the new dual lead system generator.
6. The pocket is cleaned by irrigating it with saline.
7. The new generator is placed into the pocket and attached to the existing leads.
8. The skin pocket is closed using sutures, staples, or tissue adhesive.
9. The provider programs the device for optimal functioning.

4. Qualifying circumstances

Patients eligible for CPT 33263 are those who require the removal and replacement of an implantable defibrillator pulse generator with a dual lead system. The procedure is typically performed when the existing components no longer function properly or when an infection occurs. The patient must have leads to two chambers of the heart, and the provider must be qualified to perform the procedure.

5. When to use CPT code 33263

CPT code 33263 should be used when the provider performs the removal and replacement of an implantable defibrillator pulse generator with a dual lead system. This code is specific to dual lead systems, where leads are placed in two cardiac chambers. It should not be used for other types of implantable defibrillator procedures.

6. Documentation requirements

To support a claim for CPT 33263, the provider must document the following information:

• Patient’s diagnosis and the need for the removal and replacement procedure
• Details of the procedure, including the incision, removal of the existing generator, testing of the leads, adaptation of the skin pocket (if necessary), placement of the new generator, and closure of the pocket
• Date and duration of the procedure
• Any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 33263, ensure that the provider performs the removal and replacement procedure for a dual lead system. It is important to follow the specific documentation requirements and guidelines for accurate billing. CPT code 33263 should not be reported with other codes unless additional procedures, such as defibrillator threshold testing, are performed separately. It is recommended to review the specific guidelines and tips provided by the payer to ensure proper billing and reimbursement.

8. Historical information

CPT 33263 was added to the Current Procedural Terminology system on January 1, 2012. There have been no updates or changes to the code since its addition.

9. Examples

1. A cardiologist performs the removal and replacement of an implantable defibrillator pulse generator with a dual lead system for a patient with leads to two chambers of the heart.
2. An electrophysiologist conducts the procedure to remove and replace an implantable defibrillator pulse generator with a dual lead system for a patient with a history of cardiac arrhythmias.
3. A cardiac surgeon performs the removal and replacement of an implantable defibrillator pulse generator with a dual lead system for a patient with a malfunctioning device.
4. An interventional cardiologist carries out the procedure to remove and replace an implantable defibrillator pulse generator with a dual lead system for a patient with an infected device.
5. A cardiac electrophysiologist performs the removal and replacement of an implantable defibrillator pulse generator with a dual lead system for a patient with a failed generator.
6. A cardiothoracic surgeon conducts the procedure to remove and replace an implantable defibrillator pulse generator with a dual lead system for a patient with a damaged device.
7. An interventional radiologist performs the removal and replacement of an implantable defibrillator pulse generator with a dual lead system for a patient with a dislodged lead.
8. A cardiac electrophysiologist carries out the procedure to remove and replace an implantable defibrillator pulse generator with a dual lead system for a patient with a fractured lead.
9. A cardiothoracic surgeon performs the removal and replacement of an implantable defibrillator pulse generator with a dual lead system for a patient with a malfunctioning generator.