How To Use CPT Code 33275

CPT 33275 describes the transcatheter removal of a permanent leadless pacemaker from the right ventricle, including imaging guidance and testing/programming of the leadless pacemaker when performed. 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 33275?

CPT 33275 can be used to describe the procedure of removing a permanent leadless pacemaker from the right ventricle using a steerable catheter placed through the femoral vein. This code includes imaging guidance and testing/programming of the leadless pacemaker when performed. It is important to note that this code cannot be reported in conjunction with CPT code 33274.

2. Official Description

The official description of CPT code 33275 is: ‘Transcatheter removal of permanent leadless pacemaker, right ventricular, including imaging guidance (eg, fluoroscopy, venous ultrasound, ventriculography, femoral venography), when performed.’

3. Procedure

1. The provider begins by puncturing the skin over the femoral vein and inserting a steerable catheter through an 18F sheath.
2. Under imaging guidance, the provider advances the catheter to the vena cava and then the right ventricle.
3. Using a dedicated steerable retrieval catheter, the provider engages or captures the cap of the leadless pacemaker with a snare.
4. The provider disengages the leadless pacemaker from the endocardium by turning the snare counter-clockwise for two full rotations.
5. The protective sleeve is then advanced over the device, and the provider withdraws it from the body.
6. Pressure is applied over the femoral vein to control bleeding.

4. Qualifying circumstances

CPT 33275 is performed on patients who have a permanent leadless pacemaker in the right ventricle that needs to be removed. The procedure is done using a steerable catheter placed through the femoral vein. Imaging guidance, such as fluoroscopy, venous ultrasound, ventriculography, and femoral venography, may be used during the procedure. It is important to note that CPT code 33275 cannot be reported in conjunction with certain other codes, such as those for femoral venography, fluoroscopy, ultrasound guidance for vascular access, and right ventriculography.

5. When to use CPT code 33275

CPT code 33275 should be used when a provider performs the transcatheter removal of a permanent leadless pacemaker from the right ventricle using a steerable catheter placed through the femoral vein. This code includes imaging guidance and testing/programming of the leadless pacemaker when performed. It is important to review the documentation and ensure that the procedure meets the specific requirements outlined in the code description.

6. Documentation requirements

To support a claim for CPT 33275, the provider must document the following information:

• Indication for the removal of the leadless pacemaker
• Details of the procedure, including the use of imaging guidance and any testing/programming performed
• Date of the procedure
• Start and end time of the procedure
• Any complications or adverse events that occurred
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 33275, ensure that the procedure meets the specific requirements outlined in the code description. It is important to note that CPT code 33275 cannot be reported in conjunction with certain other codes, such as those for femoral venography, fluoroscopy, ultrasound guidance for vascular access, and right ventriculography. Review the documentation and ensure accurate coding and appropriate use of modifiers if necessary.

8. Historical information

CPT 33275 was added to the Current Procedural Terminology system on January 1, 2019. There have been no updates to the code since its addition.

9. Examples

1. A provider removes a permanent leadless pacemaker from the right ventricle of a patient using a steerable catheter placed through the femoral vein. Imaging guidance is used during the procedure, and testing/programming of the leadless pacemaker is performed. The procedure is documented, and the appropriate documentation requirements are met.
2. A different provider performs the transcatheter removal of a permanent leadless pacemaker from the right ventricle of another patient. The procedure is done using a steerable catheter placed through the femoral vein, and imaging guidance is utilized. The leadless pacemaker is successfully removed, and the documentation supports the use of CPT code 33275.
3. Another provider performs the transcatheter removal of a permanent leadless pacemaker from the right ventricle of a third patient. The procedure is performed using a steerable catheter placed through the femoral vein, and imaging guidance is used. The leadless pacemaker is removed, and the documentation includes details of the procedure, as well as any testing/programming performed.