How To Use CPT Code 33264

CPT 33264 describes the procedure of removing and replacing an implantable defibrillator pulse generator with a multiple 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 33264?

CPT 33264 can be used to describe the removal and replacement of an implantable defibrillator pulse generator with a multiple lead system. This code is specifically used when the provider removes the existing generator and replaces it with a new one for a patient with leads to at least three chambers 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 33264 is: ‘Removal of implantable defibrillator pulse generator with replacement of implantable defibrillator pulse generator; multiple lead system.’

3. Procedure

1. The provider begins by appropriately prepping and anesthetizing the patient.
2. An incision is made on the skin over the subcutaneous pocket containing the existing generator.
3. The existing generator is freed from the fibrous adhesions surrounding it, and the leads are separated 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 existing skin pocket is adapted to accommodate the dimensions of the new multiple 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

CPT 33264 is used when the provider removes and replaces an implantable defibrillator pulse generator with a multiple lead system. The patient must have leads to at least three chambers of the heart. This procedure is typically performed when the existing components are no longer functioning properly or when an infection occurs.

5. When to use CPT code 33264

CPT code 33264 should be used when the provider performs the complete procedure of removing and replacing an implantable defibrillator pulse generator with a multiple lead system. This code is specific to cases where the patient has leads to at least three chambers of the heart. It should not be used for other types of implantable defibrillator procedures.

6. Documentation requirements

To support a claim for CPT 33264, the provider must document the following information:

• Reason for the removal and replacement of the implantable defibrillator pulse generator
• Details of the procedure, including the incision, removal of the existing generator, separation of leads, testing of existing leads, adaptation of the skin pocket, placement of the new generator, attachment to existing leads, closure of the skin pocket, and programming of the device
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 33264, ensure that the procedure involves the removal and replacement of an implantable defibrillator pulse generator with a multiple lead system. It should not be reported in conjunction with other specific codes related to defibrillator pulse generator removal or replacement. Additional codes may be used for related procedures, such as defibrillator threshold testing.

8. Historical information

CPT 33264 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 provider removes and replaces an implantable defibrillator pulse generator with a multiple lead system for a patient with leads to three chambers of the heart.
2. A patient requires the removal and replacement of an implantable defibrillator pulse generator with a multiple lead system due to malfunctioning components.
3. A provider performs the procedure of removing and replacing an implantable defibrillator pulse generator with a multiple lead system for a patient with leads to four chambers of the heart.
4. An infection occurs, necessitating the removal and replacement of an implantable defibrillator pulse generator with a multiple lead system for a patient with leads to three chambers of the heart.
5. A provider replaces an existing implantable defibrillator pulse generator with a new one for a patient with leads to three chambers of the heart.
6. A patient undergoes the removal and replacement of an implantable defibrillator pulse generator with a multiple lead system as part of a scheduled procedure.
7. A provider performs the complete procedure of removing and replacing an implantable defibrillator pulse generator with a multiple lead system for a patient with leads to three chambers of the heart.
8. An existing implantable defibrillator pulse generator is removed and replaced with a new one for a patient with leads to three chambers of the heart.
9. A patient requires the removal and replacement of an implantable defibrillator pulse generator with a multiple lead system due to a failed device.
10. A provider performs the procedure of removing and replacing an implantable defibrillator pulse generator with a multiple lead system for a patient with leads to three chambers of the heart, ensuring optimal functioning of the device.