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2025 CPT code 33220

Repair of two transvenous electrodes for a permanent pacemaker or implantable defibrillator.

Adhere to the most current CPT coding guidelines and the instructions specific to cardiac device procedures.

Modifiers may be applicable depending on the circumstances of the procedure.Consult current CPT guidelines and local payer policies for applicable modifiers.

The procedure is medically necessary when two transvenous leads of a pacemaker or implantable defibrillator are malfunctioning, causing significant disruption to device function. Repair is usually preferred to complete device replacement, unless lead damage is too extensive.

The physician performs the procedure, which includes opening the device pocket, disconnecting and testing the electrodes, repairing the electrodes, retesting the system, reconnecting the electrodes, and closing the pocket.

IMPORTANT:If the repair involves replacing the pulse generator, use code 33220 in conjunction with codes 33228, 33229, 33263, or 33264, as appropriate.For repair of a single electrode, use CPT code 33218.

In simple words: The doctor fixes two wires (electrodes) inside the heart that are part of a pacemaker or defibrillator. These wires are disconnected, checked for problems, repaired if needed, and then reconnected.

This CPT code reports the repair of two transvenous electrodes from a permanent pacemaker or implantable cardioverter-defibrillator (ICD) pulse generator.The procedure involves disconnecting the electrodes, testing their functionality, repairing any defects, retesting, and reattaching them to the generator.The pulse generator is typically removed to access the electrodes. This is distinct from replacing the pulse generator itself.

Example 1: A patient with a dual-chamber pacemaker experiences malfunction due to damage to two transvenous leads.The physician performs the repair using 33220., A patient with an ICD experiences intermittent failure of two leads. After thorough evaluation, the physician repairs the two leads using 33220., Following a trauma, a patient's dual-chamber pacemaker has two leads damaged. The physician repairs these leads under fluoroscopic guidance using 33220.

Pre-operative assessment, operative report detailing the repair process, including lead testing results, intraoperative images (if applicable), and post-operative assessment of device function.

** This procedure is typically performed in a specialized electrophysiology lab or operating room under fluoroscopic guidance.Documentation should clearly indicate the specific malfunction and the nature of the repair.

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