2025 CPT code 33217
Insertion of two transvenous electrodes, permanent pacemaker or implantable defibrillator.
Modifiers may be applicable. Modifier 51 is used to indicate multiple procedures during the same session. Modifier 78 is used to indicate a return to the operating room for a related procedure during the postoperative period.
Medical necessity for this procedure must be supported by documentation of lead malfunction, such as loss of capture, sensing issues, or lead fracture. The documentation should clearly demonstrate that lead replacement is necessary for the proper functioning of the pacemaker or ICD system.
After prepping and anesthetizing the patient, the physician tests the existing leads and removes the pulse generator. Using imaging guidance, new electrode catheters are inserted through a vein, typically subclavian or jugular, into the heart. The old electrodes are removed, and new leads are placed through the catheters and connected to the pulse generator. The system’s functionality is then evaluated.
In simple words: The doctor inserts two wires through a vein into your heart. These wires connect to a pacemaker or defibrillator that's already in your body. This is done if the old wires aren't working right.
This code reports the insertion of two transvenous electrodes for a permanent pacemaker or implantable cardioverter-defibrillator (ICD), not including the pulse generator.The electrodes are inserted through a vein into the heart chambers. This procedure is typically performed when the existing leads are malfunctioning or need replacement.
Example 1: A patient with a dual-chamber pacemaker experiences loss of capture due to lead failure. The physician removes the old leads and inserts two new transvenous electrodes, connecting them to the existing pulse generator., A patient's ICD lead fractures. The physician performs a lead extraction procedure to remove the broken lead and then inserts two new transvenous leads for the ICD system., During a device upgrade, a physician replaces a single-lead pacemaker system with a dual-chamber system. They remove the old lead and insert two new transvenous leads, along with a new pulse generator (using a different code to report the generator replacement).
Documentation should include: Indication for lead replacement (e.g., lead fracture, malfunction), Method of lead insertion (transvenous), Number of leads inserted, Location of lead placement (e.g., right atrium, right ventricle), Fluoroscopic or imaging guidance used, Device evaluation results after the procedure.
- Specialties:Cardiac Electrophysiology, Cardiothoracic Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center