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2025 CPT code 33227

Removal and replacement of a permanent pacemaker pulse generator in a single-lead system.

Adhere to all CPT coding guidelines and the instructions provided in this code's description. Accurate documentation is crucial to support the use of this code.

Modifiers may be applicable based on circumstances such as multiple procedures, reduced services, or other qualifying events.Refer to the CPT manual for appropriate modifier usage.

Medical necessity is established when the existing pacemaker generator malfunctions or the battery depletes, necessitating replacement for continued appropriate pacing functionality and to avoid life-threatening arrhythmias.

The clinical responsibility rests with the cardiologist or cardiac surgeon performing the procedure.This includes pre-operative assessment, obtaining informed consent, performing the surgery, post-operative monitoring, and follow-up care.

IMPORTANT:If the procedure involves a dual-lead system, code 33228 should be used.If only the pulse generator is removed without replacement, code 33233 is appropriate.If the procedure also involves lead insertion or replacement, more comprehensive system codes (33206-33208) would be used.

In simple words: The doctor removes the old pacemaker battery and replaces it with a new one. This is done for a pacemaker that only has one wire going to the heart.

This CPT code, 33227, encompasses the removal of an existing permanent pacemaker pulse generator and its replacement with a new one, specifically within a single-lead pacemaker system.The procedure involves accessing the subcutaneous pocket containing the generator, carefully disconnecting the generator from the lead, removing the old generator, preparing the pocket as needed, inserting the new generator, connecting it to the existing lead, ensuring hemostasis, and closing the incision.Radiological supervision and interpretation are included.

Example 1: A 70-year-old patient with a single-chamber pacemaker experiences battery depletion. The cardiologist performs a pulse generator replacement using code 33227., A 65-year-old patient with a single-lead pacemaker requires a generator replacement due to malfunction. The existing lead is functional, and code 33227 is used., An 80-year-old patient experiences a pacemaker generator failure. The cardiologist replaces the generator, leaving the single lead intact. Code 33227 is reported.

* Pre-operative assessment and history, including the reason for generator replacement.* Intraoperative notes detailing the procedure, including lead assessment.* Post-operative assessment and device functionality testing.* Patient consent form.

** Always verify the specific payer's coding requirements and coverage policies before submitting claims.Accurate coding requires detailed and complete documentation.

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