How To Use CPT Code 33285

CPT 33285 refers to the insertion and programming of a subcutaneous cardiac rhythm monitor, and this article will cover its description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples.

1. What is CPT 33285?

CPT 33285 is a medical procedure code that describes the insertion and programming of a subcutaneous cardiac rhythm monitor. This device is used to continuously monitor a patient’s heart rhythm and detect any abnormalities, such as arrhythmias, which can be life-threatening if left untreated. The code is used by medical coders and billers to accurately document and bill for this specific procedure.

2. 33285 CPT code description

The official description of CPT code 33285 is: “Insertion, subcutaneous cardiac rhythm monitor, including programming.”

3. Procedure

The 33285 procedure involves the following steps:

1. The patient is appropriately prepped, and local anesthesia is administered.
2. The provider makes an incision in the skin of the left upper chest.
3. A small subcutaneous pocket is created for the implantation of the cardiac rhythm monitor.
4. The device is positioned according to the manufacturer’s instructions.
5. The provider tests the device to verify adequate function and sutures it in place.
6. The incision is closed, and the device is programmed according to the manufacturer’s directions.
7. The patient is educated on the use and maintenance of the device.

4. Qualifying circumstances

Patients who are eligible to receive CPT code 33285 services are those who have been diagnosed with or are at risk for developing cardiac arrhythmias, such as atrial fibrillation, ventricular tachycardia, or bradycardia. These patients may have experienced symptoms such as palpitations, dizziness, syncope, or chest pain, which could indicate an underlying heart rhythm disorder. Additionally, patients who have undergone previous cardiac procedures or have a family history of sudden cardiac death may also be considered for this procedure.

5. When to use CPT code 33285

It is appropriate to bill the 33285 CPT code when a provider has performed the insertion and programming of a subcutaneous cardiac rhythm monitor for a patient who meets the qualifying circumstances mentioned above. The procedure should be medically necessary and supported by appropriate documentation to justify its use.

6. Documentation requirements

To support a claim for CPT 33285, the following information should be documented:

• Patient’s medical history, including any previous cardiac procedures or family history of sudden cardiac death.
• Physical examination findings, including any signs or symptoms suggestive of a cardiac arrhythmia.
• Diagnostic test results, such as electrocardiograms (ECGs) or Holter monitor recordings, that demonstrate the presence or risk of arrhythmias.
• A detailed description of the procedure, including the steps taken, the type of device used, and any complications encountered.
• Post-procedure care instructions and patient education provided.

7. Billing guidelines

When billing for CPT code 33285, it is essential to follow the specific guidelines and rules set forth by the payer. Some general tips for billing this code include:

• Ensure that the patient meets the qualifying circumstances for the procedure.
• Document all necessary information to support the medical necessity of the procedure.
• Verify that the procedure is covered by the patient’s insurance plan and obtain any required pre-authorizations.
• Use appropriate modifiers, if necessary, to indicate any special circumstances related to the procedure.

8. Historical information

CPT 33285 was added to the Current Procedural Terminology system on January 1, 2019. There have been no updates to the code since its addition.

9. Similar codes to CPT 33285

Five similar codes to CPT 33285 and how they differ are:

• CPT 33284: This code describes the removal of a subcutaneous cardiac rhythm monitor, whereas CPT 33285 involves the insertion and programming of the device.
• CPT 33262: This code refers to the removal and replacement of a permanent single chamber cardioverter-defibrillator pulse generator, which is a different type of cardiac device than the subcutaneous cardiac rhythm monitor.
• CPT 33271: This code is for the insertion of a subcutaneous implantable defibrillator system, which is designed to treat life-threatening ventricular arrhythmias, unlike the cardiac rhythm monitor used in CPT 33285.
• CPT 33249: This code involves the insertion or replacement of a permanent dual chamber cardioverter-defibrillator pulse generator, another type of cardiac device that differs from the subcutaneous cardiac rhythm monitor.
• CPT 33225: This code describes the insertion of a pacing electrode for a cardiac resynchronization therapy device, which is a different procedure and device than the subcutaneous cardiac rhythm monitor in CPT 33285.

10. Examples

Here are 10 detailed examples of CPT code 33285 procedures:

1. A 65-year-old patient with a history of atrial fibrillation and recurrent syncope undergoes the insertion and programming of a subcutaneous cardiac rhythm monitor to continuously monitor their heart rhythm.
2. A 45-year-old patient with a family history of sudden cardiac death and unexplained palpitations receives a subcutaneous cardiac rhythm monitor to detect any potential arrhythmias.
3. A 70-year-old patient with a history of ventricular tachycardia and previous cardiac ablation undergoes the insertion and programming of a subcutaneous cardiac rhythm monitor to monitor their heart rhythm for any recurrence of arrhythmias.
4. A 55-year-old patient with a history of bradycardia and dizziness receives a subcutaneous cardiac rhythm monitor to continuously monitor their heart rate and detect any episodes of slow heart rhythms.
5. A 60-year-old patient with a history of congestive heart failure and recurrent atrial fibrillation undergoes the insertion and programming of a subcutaneous cardiac rhythm monitor to monitor their heart rhythm and guide future treatment decisions.
6. A 50-year-old patient with a history of syncope and abnormal ECG findings receives a subcutaneous cardiac rhythm monitor to detect any underlying arrhythmias that may be causing their symptoms.
7. A 75-year-old patient with a history of coronary artery disease and recurrent chest pain undergoes the insertion and programming of a subcutaneous cardiac rhythm monitor to monitor their heart rhythm for any potential arrhythmias.
8. A 40-year-old patient with a history of palpitations and a positive stress test receives a subcutaneous cardiac rhythm monitor to continuously monitor their heart rhythm and detect any exercise-induced arrhythmias.
9. A 67-year-old patient with a history of atrial flutter and previous catheter ablation undergoes the insertion and programming of a subcutaneous cardiac rhythm monitor to monitor their heart rhythm for any recurrence of arrhythmias.
10. A 72-year-old patient with a history of non-sustained ventricular tachycardia and a previous myocardial infarction receives a subcutaneous cardiac rhythm monitor to continuously monitor their heart rhythm and detect any life-threatening arrhythmias.