2025 CPT code 33213
(Active) Effective Date: N/A Revision Date: N/A Cardiovascular Surgery - Pacemaker or Implantable Defibrillator Procedures Surgery Feed
Insertion of a pacemaker pulse generator only with existing dual leads.
Modifiers may be applicable depending on the circumstances of the procedure.Consult the CPT manual for further information.
Medical necessity for code 33213 is established when the existing pacemaker leads function correctly, and only the pulse generator requires replacement due to battery depletion or documented malfunction.Documentation should clearly indicate this situation to prevent denials.
The physician or qualified healthcare professional is responsible for preparing the patient, creating a subcutaneous pocket (if needed), connecting the new pulse generator to the existing leads, testing functionality, and closing the incision.Appropriate post-operative care and follow-up are also part of their clinical responsibility.
In simple words: The doctor puts in a new battery (pulse generator) for your existing dual-lead pacemaker.They connect the new battery to your existing wires and close the incision.
This CPT code, 33213, represents the insertion of a pacemaker pulse generator only, assuming existing dual leads are already in place.The procedure involves accessing the existing pacemaker pocket, connecting the new pulse generator to the pre-existing leads, and closing the pocket.It does not include the insertion or replacement of leads. Radiological supervision and imaging are included.
Example 1: A patient with a dual-chamber pacemaker experiences battery depletion. The physician performs a generator replacement using code 33213., A patient has an existing dual-lead pacemaker system. The pulse generator malfunctions, necessitating replacement. The physician uses code 33213 to bill for the generator change only., A patient's dual-lead pacemaker generator needs replacing due to a documented malfunction.The leads remain functional and do not require any replacement. Code 33213 is used.
Pre-operative assessment, including patient history and physical examination; operative report detailing the procedure performed, including confirmation of lead functionality and connection to the new generator; post-operative assessment and plan of care.Documentation must support the medical necessity for the procedure, which could include evidence of generator malfunction.
** Always confirm the number of leads present before selecting this code. Incorrect coding can lead to claim denials or payment issues.This code does not include lead insertion or removal procedures.These should be reported separately using the appropriate CPT code.
- Payment Status: Active
- Modifier TC rule: Not applicable for this code.
- Specialties:Cardiology, Cardiac Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgery Center