© Copyright 2025 American Medical Association. All rights reserved.
The procedure described by CPT® Code 33262 involves the removal and replacement of an implantable defibrillator pulse generator within a single lead system. This procedure is typically performed when the existing pulse generator is malfunctioning or when its battery is nearing depletion. An implantable defibrillator is a critical device used in the management of patients with life-threatening arrhythmias. It continuously monitors the heart's electrical activity and is capable of delivering anti-tachycardia pacing to prevent rapid and irregular heart rhythms. Additionally, it can provide defibrillation shocks to restore a normal heart rhythm in the event of severe arrhythmias. The pulse generator is surgically located in the subcutaneous tissue of the left chest, necessitating an incision to access the device. The procedure requires careful dissection to free the pulse generator from surrounding tissue, followed by the disconnection of the electrode(s) from the old generator. After the removal of the old device, the new pulse generator is connected to the existing lead(s) and tested to ensure proper functionality. The patient is monitored for the appropriate response to induced arrhythmias before the new generator is securely placed back into the pocket and the incision is closed. This procedure is essential for maintaining the effectiveness of the defibrillator system in managing potentially life-threatening cardiac conditions.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure associated with CPT® Code 33262 is indicated for patients who require the replacement of an implantable defibrillator pulse generator due to specific conditions or symptoms. These include:
The procedure for CPT® Code 33262 involves several critical steps to ensure the safe and effective replacement of the implantable defibrillator pulse generator. Each step is outlined as follows:
After the procedure, patients are typically monitored for any immediate complications and to ensure the new pulse generator is functioning correctly. Follow-up care may include regular check-ups to assess the device's performance and battery status. Patients may also receive instructions regarding activity restrictions and signs of potential complications, such as infection or device malfunction, that should prompt immediate medical attention. Proper post-procedure care is essential to ensure the long-term success of the implantable defibrillator system.
| Short Descr | RMVL& REPLC PULSE GEN 1 LEAD | Medium Descr | RMVL IMPLTBL DFB PLSE GEN W/REPL PLSE GEN 1 LEAD | Long Descr | Removal of implantable defibrillator pulse generator with replacement of implantable defibrillator pulse generator; single lead system | 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) | P2F - Major procedure, cardiovascular-Other | MUE | 1 | CCS Clinical Classification | 48 - Insertion, revision, replacement, removal of cardiac pacemaker or cardioverter/defibrillator |
| Q0 | Investigational clinical service provided in a clinical research study that is in an approved clinical research study | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 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. | 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 | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | CR | Catastrophe/disaster related | ET | Emergency services | GC | This service has been performed in part by a resident under the direction of a teaching physician | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | GZ | Item or service expected to be denied as not reasonable and necessary | KX | Requirements specified in the medical policy have been met | KY | Dmepos item subject to dmepos competitive bidding program number 5 | LT | Left side (used to identify procedures performed on the left side of the body) | SC | Medically necessary service or supply | 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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| 2021-01-01 | Note | Guidelines changed. |
| 2017-01-01 | Changed | Moderate (Conscious) Sedation flag removed. See new Moderate Sedation category. |
| 2015-01-01 | Changed | Description Changed |
| 2013-01-01 | Changed | Medium Descriptor changed. |
| 2012-01-01 | Added | Added |
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