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2025 CPT code 33218

Repair of a single transvenous electrode in a permanent pacemaker or implantable cardioverter-defibrillator.

Adhere to the current CPT coding guidelines for cardiovascular procedures.Accurate documentation of the type of device (pacemaker or ICD), number of leads, and nature of the repair is crucial.

Modifiers may be applicable depending on the circumstances of the procedure, such as modifier 59 (distinct procedural service) if additional services are performed during the same session.

Medical necessity is established when there's a documented malfunction of a single transvenous electrode impacting the functionality of the implanted cardiac device.The repair must be deemed medically necessary to restore the device's function and prevent life-threatening arrhythmias.

The procedure is performed by a cardiologist or cardiac surgeon. It involves surgical incision of the device pocket, disconnection and repair of the electrode, testing, reconnection, and closure of the incision.Post-operative monitoring is also part of the clinical responsibility.

IMPORTANT:For repair with pulse generator replacement, see codes 33227, 33228, 33229, 33262, 33263, 33264, and 33218.

In simple words: This code covers fixing a single wire (electrode) in a pacemaker or defibrillator that's implanted in the heart. The doctor disconnects the wire, repairs it, tests it, reconnects it, and makes sure everything works properly.

This CPT code encompasses the repair of a single transvenous electrode (lead) within a permanently implanted cardiac device, such as a pacemaker or implantable cardioverter-defibrillator (ICD).The procedure involves disconnecting the defective electrode, performing the necessary repairs, testing its functionality, reconnecting it to the pulse generator, and verifying the restored system performance. This is distinct from procedures involving pulse generator replacement.

Example 1: A patient with a single-chamber pacemaker experiences intermittent loss of pacing due to a fractured lead. The cardiologist performs a surgical repair of the affected lead using code 33218., A patient with a dual-chamber ICD presents with malfunctioning ventricular sensing. After diagnostic evaluation, the cardiologist identifies a faulty ventricular lead and repairs it using 33218., Following a trauma, a patient with a pacemaker suffers from a dislodged atrial lead.The cardiothoracic surgeon repairs the lead using 33218.

** This code should not be used if the pulse generator is also replaced.If multiple electrodes require repair, the appropriate multiple-lead repair code should be used instead.

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