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2025 CPT code 33206

Insertion or replacement of a permanent pacemaker with transvenous electrode(s) in the right atrium.

Follow current CPT guidelines for pacemaker implantation.Consult official CPT and payer guidelines for specific coding and reimbursement rules.

Modifiers may be applicable depending on the specific circumstances of the procedure.Consult official guidelines for appropriate modifier use.

Medical necessity for pacemaker implantation is typically established by documentation of symptomatic bradycardia (slow heart rate) or other conditions that necessitate cardiac pacing to maintain adequate heart function.Specific criteria may vary based on payer policies.

The physician is responsible for pre-operative preparation, creating an incision, inserting the electrode catheter, using imaging guidance to position the electrode, implanting leads and pulse generator, evaluating, and programming the pacemaker. Post-operative care may be included depending on the payer and specific service agreement.

IMPORTANT:33207 (ventricular), 33208 (atrial and ventricular).If a dual-chamber system upgrade is performed, 33214 should be used instead.

In simple words: The doctor puts in a new or replaces an existing permanent pacemaker.This involves placing a small device under the skin to help the heart beat regularly, with wires going to the upper right chamber of the heart.

This code encompasses the insertion or replacement of a permanent pacemaker system involving transvenous electrodes specifically located within the right atrium.The procedure includes creating a subcutaneous pocket for the pulse generator, inserting the electrode catheter via a vein, using imaging guidance to position the electrode in the right atrium, connecting the leads to the pulse generator, implanting the pulse generator, and performing device evaluation and programming.

Example 1: A 70-year-old patient presents with symptomatic bradycardia.A permanent single-chamber pacemaker is implanted in the right atrium to address the slow heart rate., A 65-year-old patient with a malfunctioning pacemaker undergoes replacement of the pulse generator and atrial lead. Code 33206 is used for the atrial lead replacement., A patient requires a new pacemaker implantation due to a newly diagnosed condition causing bradycardia requiring a single-chamber atrial pacemaker.

Pre-operative assessment, including patient history, physical examination findings, electrocardiogram (ECG), and echocardiogram (if needed). Intraoperative documentation should include details of the surgical technique, lead placement location (confirmed by fluoroscopy or other imaging), pulse generator model, programming parameters, and post-implantation ECG. Post-operative documentation should include details of any complications and follow-up care.

** Radiological supervision and interpretation are included in the code.Right heart catheterization is not usually reported with this code unless performed for a distinct reason.

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