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The CPT® Code 33211 refers to the insertion or replacement of temporary transvenous dual chamber pacing electrodes, which is classified as a separate procedure. This procedure involves the placement of a temporary cardiac pacemaker transvenous electrode or catheter, which is essential for managing certain heart rhythm disorders. A cardiac pacemaker functions by delivering electronic impulses to the heart at a programmed rate, thereby assisting the heart in maintaining a normal rhythm. Temporary pacemakers are particularly utilized in cases of temporary arrhythmias that are anticipated to resolve on their own or as a bridge until a permanent pacemaker can be implanted. The temporary pacing systems can be categorized into single chamber systems, which may target either the atrium or ventricle, and dual chamber systems that engage both the atrial and ventricular chambers. The leads for these systems can be positioned either on the surface of the heart (epicardial) or within the heart chamber (endocardial). The transvenous approach specifically refers to the placement of leads within the heart chamber, which is achieved through a minimally invasive technique. This involves making an incision in the upper chest to access the cephalic, subclavian, or jugular vein, through which a sheath is inserted. Under radiological guidance, the pacemaker wire is advanced into the appropriate heart chamber, ensuring that the lead is correctly positioned against the heart wall. In the case of a dual chamber device, a second wire is introduced to the other chamber, and both leads are tested for functionality before being connected to a pulse generator. This procedure is critical for patients requiring temporary pacing support, ensuring that their heart rhythm is stabilized during a critical period.
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The procedure associated with CPT® Code 33211 is indicated for specific clinical scenarios where temporary pacing support is necessary. The following conditions may warrant the insertion or replacement of temporary transvenous dual chamber pacing electrodes:
The procedure for the insertion or replacement of temporary transvenous dual chamber pacing electrodes involves several critical steps to ensure proper placement and functionality of the pacing system. The following procedural steps are outlined:
Post-procedure care following the insertion or replacement of temporary transvenous dual chamber pacing electrodes involves monitoring the patient for any complications and ensuring the pacing system is functioning correctly. Patients are typically observed for signs of infection at the incision site, lead dislodgment, or any adverse reactions to the procedure. Continuous cardiac monitoring is essential to assess the effectiveness of the pacing and to ensure that the heart rhythm remains stable. Patients may be advised on activity restrictions to prevent lead displacement and to promote healing at the incision site. Follow-up evaluations are necessary to determine if the temporary pacing is still required or if a transition to a permanent pacemaker is needed.
| Short Descr | INSERT CARD ELECTRODES DUAL | Medium Descr | INSJ/RPLCMT TEMP TRANSVNS 2CHMBR PACG ELTRDS SPX | Long Descr | Insertion or replacement of temporary transvenous dual chamber pacing electrodes (separate procedure) | Status Code | Active Code | Global Days | 000 - Endoscopic or Minor Procedure | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P2E - Major procedure, cardiovascular-Pacemaker insertion | MUE | 1 | CCS Clinical Classification | 48 - Insertion, revision, replacement, removal of cardiac pacemaker or cardioverter/defibrillator |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | KX | Requirements specified in the medical policy have been met | X1 | Continuous/broad services: for reporting services by clinicians, who provide the principal care for a patient, with no planned endpoint of the relationship; services in this category represent comprehensive care, dealing with the entire scope of patient problems, either directly or in a care coordination role; reporting clinician service examples include, but are not limited to: primary care, and clinicians providing comprehensive care to patients in addition to specialty care | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2017-01-01 | Changed | Moderate (Conscious) Sedation flag removed. See new Moderate Sedation category. |
| 1994-01-01 | Added | First appearance in code book in 1994. |
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