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The procedure described by CPT® Code 33240 involves the insertion of an implantable defibrillator pulse generator, specifically in patients who already have a single lead in place. This device, commonly known as an automatic implantable cardioverter-defibrillator (AICD or ICD), plays a critical role in managing heart rhythm disorders. The AICD continuously monitors the heart's electrical activity and is designed to deliver various therapeutic interventions. These include anti-tachycardia pacing, which helps to prevent rapid and irregular heart rhythms; backup pacing, which ensures the heart maintains a healthy rhythm; cardioversion, which uses a mild electrical shock to restore a normal heart rhythm; and defibrillation, which employs a stronger shock to correct dangerously abnormal rhythms or to restart the heart in cases of cardiac arrest. During the procedure, the physician makes an incision in the skin, typically located in the left pectoral region, to create a subcutaneous pocket where the pulse generator will be placed. The existing lead is then connected to the new pulse generator, and the functionality of both the lead and the generator is tested to ensure they are operating correctly. Once confirmed, the pulse generator is securely positioned within the pocket, sutured to the underlying tissue, and the incision site is closed. This procedure is essential for patients requiring ongoing cardiac monitoring and intervention to prevent life-threatening arrhythmias.
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The insertion of an implantable defibrillator pulse generator, as described by CPT® Code 33240, is indicated for patients who have an existing single lead and require an upgrade or replacement of their defibrillator system. The following conditions may warrant this procedure:
The procedure for the insertion of the implantable defibrillator pulse generator involves several key steps, which are detailed as follows:
Post-procedure care for patients who have undergone the insertion of an implantable defibrillator pulse generator includes monitoring for any immediate complications, such as infection or bleeding at the incision site. Patients are typically advised to avoid strenuous activities and heavy lifting for a specified period to allow for proper healing. Follow-up appointments are essential to assess the functionality of the device and to make any necessary adjustments. Patients may also receive education on recognizing signs of potential complications and the importance of adhering to scheduled device checks to ensure ongoing effectiveness in managing their heart rhythm.
| Short Descr | INSRT PULSE GEN W/SINGL LEAD | Medium Descr | INSJ IMPLNTBL DEFIB PULSE GEN W/1 EXISTING LD | Long Descr | Insertion of implantable defibrillator pulse generator only; with existing single lead | 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 | 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 |
This is a primary code that can be used with these additional add-on codes.
| 33225 | Addon Code MPFS Status: Active Code APC N ASC N1 Physician Quality Reporting PUB 100 CPT Assistant Article Insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertion of implantable defibrillator or pacemaker pulse generator (eg, for upgrade to dual chamber system) (List separately in addition to code for primary procedure) |
| 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). | 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. | CR | Catastrophe/disaster related | 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 | Q0 | Investigational clinical service provided in a clinical research study that is in an approved clinical research study | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 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 |
| 1994-01-01 | Added | First appearance in code book in 1994. |
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