© Copyright 2025 American Medical Association. All rights reserved.
The insertion of a subcutaneous implantable defibrillator electrode, as described by CPT® Code 33271, involves the placement of a specialized lead wire designed to monitor and treat life-threatening arrhythmias. This lead wire, known as a multi-lumen polymeric tube, is equipped with sensing electrodes and a defibrillator shocking coil, which work together to detect abnormal heart rhythms and deliver electrical shocks when necessary to restore normal heart function. The procedure is performed through a series of precise anatomical landmarks on the left side of the chest, ensuring accurate placement of the electrode for optimal performance. The process begins with the identification and marking of specific sites on the chest, including the sixth rib and the second intercostal space, which are critical for the distal and proximal lead placements. Small incisions are made to facilitate the insertion of the lead wire, which is then tunneled under the skin to connect the distal and proximal sites. The lead wire is anchored securely to the fascia to prevent movement, and if a pulse generator is involved, it is connected to the lead wire to complete the system. The entire setup is tested to ensure functionality before closing the incisions, making this procedure a vital intervention for patients at risk of sudden cardiac arrest.
© Copyright 2025 Coding Ahead. All rights reserved.
The insertion of a subcutaneous implantable defibrillator electrode is indicated for patients who are at high risk for life-threatening ventricular arrhythmias, including those with a history of cardiac arrest, symptomatic ventricular tachycardia, or those with significant structural heart disease. This procedure is particularly relevant for individuals who may not be suitable candidates for traditional transvenous defibrillator systems due to anatomical considerations or other medical conditions.
The procedure for the insertion of a subcutaneous implantable defibrillator electrode involves several critical steps to ensure proper placement and functionality of the device.
Post-procedure care for patients who have undergone the insertion of a subcutaneous implantable defibrillator electrode includes monitoring for any signs of complications such as infection, bleeding, or lead dislodgment. Patients are typically advised to avoid strenuous activities for a specified period to allow for proper healing. Follow-up appointments are essential to assess the function of the defibrillator and to ensure that the lead wire remains securely in place. Additionally, patients may receive instructions on how to recognize potential issues with the device and when to seek medical attention.
| Short Descr | INSJ SUBQ IMPLTBL DFB ELCTRD | Medium Descr | INSJ OF SUBQ IMPLANTABLE DEFIBRILLATOR ELECTRODE | Long Descr | Insertion of subcutaneous implantable defibrillator electrode | 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 |
| 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). | 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.) | 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 |
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