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The procedure described by CPT® Code 33273 involves the repositioning of a previously implanted subcutaneous implantable defibrillator electrode. This procedure may be necessary when there is movement of the electrode, which can affect the device's functionality and the patient's safety. The process is performed under general anesthesia or monitored anesthesia care (MAC), along with local anesthesia to ensure patient comfort. The surgical area, specifically the anterior and left lateral chest, is meticulously prepped and draped to maintain a sterile environment. The procedure requires careful dissection to access the pulse generator pocket, where the electrode is located. The electrode is then disconnected from the pulse generator, allowing for repositioning. This involves the use of a sheath and possibly a tunneling tool to navigate the electrode through the subcutaneous tissue, ensuring it is placed back into an optimal position. After repositioning, the electrode is reconnected to the pulse generator, and the device is tested to confirm its proper functioning before the incisions are closed. This detailed approach ensures that the electrode is accurately placed, which is critical for the effective operation of the implantable defibrillator.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure for repositioning a previously implanted subcutaneous implantable defibrillator electrode is indicated in specific clinical scenarios where the electrode has experienced movement or displacement. This may occur due to various factors, including patient activity, anatomical changes, or complications related to the initial implantation. The primary indications for this procedure include:
The procedure for repositioning the subcutaneous implantable defibrillator electrode involves several critical steps to ensure successful repositioning and device functionality. The steps are as follows:
Post-procedure care following the repositioning of the subcutaneous implantable defibrillator electrode includes monitoring the patient for any immediate complications, such as bleeding or infection at the incision site. 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 healing process and to ensure that the defibrillator is functioning as intended. Patients may also receive instructions regarding wound care and signs of potential complications that should prompt immediate medical attention.
| Short Descr | REPOS PREV IMPLTBL SUBQ DFB | Medium Descr | REPOS PREVIOUSLY IMPLANTED SUBQ IMPLANTABLE DFB | Long Descr | Repositioning of previously implanted 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 | 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 |
| 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.) | 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 |
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| 2015-01-01 | Added | Added |
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