© Copyright 2025 American Medical Association. All rights reserved.
The procedure described by CPT® Code 33220 involves the repair of two transvenous electrodes that are part of a permanent pacemaker or an implantable defibrillator system. Transvenous electrodes are critical components that facilitate the delivery of electrical impulses to the heart, ensuring proper cardiac function. When these electrodes malfunction, it can lead to serious complications, necessitating repair to restore their functionality. The common issues that may require repair include electrode fractures, insulation defects, or terminal pin defects. The process begins with testing the electrode wire to identify any malfunctions. If a problem is detected, a surgical incision is made in the upper chest to access the malfunctioning electrode wire. The repair technique varies depending on the type of defect. For instance, in the case of an electrode fracture, an in-situ repair technique is employed, which involves placing a sheath and inserting a guide wire into the blood vessel containing the electrode wire. This allows for the bypassing of the broken section with a new wire segment. Similarly, insulation defects or terminal pin defects are addressed using comparable methods, ensuring that the integrity of the electrode is restored. After the repair is completed, the lead is tested to confirm that it is functioning correctly. This procedure is specifically coded as CPT® 33220 when two electrodes are repaired, distinguishing it from CPT® 33218, which is used for the repair of a single electrode.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure coded as CPT® 33220 is indicated for patients who have malfunctioning transvenous electrodes associated with a permanent pacemaker or implantable defibrillator. The specific indications for performing this repair include:
The procedure for repairing two transvenous electrodes involves several critical steps, each designed to ensure the effective restoration of the electrode's functionality. The steps are as follows:
Post-procedure care following the repair of two transvenous electrodes includes monitoring the patient for any signs of complications, such as infection or improper function of the electrodes. Patients may be advised to limit physical activity for a specified period to allow for proper healing. Follow-up appointments are typically scheduled to assess the functionality of the electrodes and ensure that the pacemaker or defibrillator is operating as intended. Documentation of the procedure and any findings during the repair is essential for future reference and continuity of care.
| Short Descr | REPAIR LEAD PACE-DEFIB DUAL | Medium Descr | RPR 2 TRANSVNS ELECTRODES PRM PM/IMPLANTABLE DFB | Long Descr | Repair of 2 transvenous electrodes for permanent pacemaker or implantable defibrillator | Status Code | Active Code | Global Days | 090 - Major Surgery | 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 | Procedure or Service, Multiple Reduction Applies | ASC Payment Indicator | Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight. | 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). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 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.) | AO | Alternate payment method declined by provider of service | 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 | GZ | Item or service expected to be denied as not reasonable and necessary | KX | Requirements specified in the medical policy have been met | LT | Left side (used to identify procedures performed on the left side of the body) | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2017-01-01 | Changed | Moderate (Conscious) Sedation flag removed. See new Moderate Sedation category. |
| 2015-01-01 | Changed | Description Changed |
| 2012-01-01 | Changed | Description Changed |
| 2011-01-01 | Changed | Short description changed. |
| 2010-01-01 | Changed | Code description changed. |
| 1994-01-01 | Added | First appearance in code book in 1994. |
Get instant expert-level medical coding assistance.