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2025 CPT code 33229

Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator; multiple lead system.

This code is specific to multiple-lead systems (three or more leads). It includes radiological supervision and interpretation.Conscious sedation codes should be reported separately, if applicable.

Modifiers may be applicable. Modifier 22 may be used to indicate increased procedural services.

Medical necessity must be clearly documented. This could include battery depletion, device malfunction, infection, or other conditions that compromise the function of the existing pulse generator.

The physician prepares the patient and administers anesthesia. An incision is made to open the subcutaneous pocket containing the existing generator. The generator is carefully removed. Existing leads are inspected and tested. The pocket may be adjusted to fit the new generator. The new generator is connected to the leads and placed into the pocket. The pocket is then closed with sutures, staples, or tissue adhesive.The new device is programmed.

In simple words: The doctor replaces the old battery of your pacemaker with a new one. Your pacemaker has leads in at least three chambers of your heart.

This procedure involves the removal of a permanent pacemaker pulse generator and its replacement with a new one in a multiple lead system (three or more leads).The existing leads are checked for functionality and the pocket is revised as needed to accommodate the new generator. This code includes radiological supervision and interpretation.

Example 1: A patient with a pacemaker system with leads in the right atrium, right ventricle, and left ventricle requires replacement of the pulse generator due to battery depletion., A patient's pacemaker pulse generator has become infected, requiring removal of the old generator and replacement with a new one.The existing leads are retained., A patient experiences a malfunction with their multiple lead pacemaker, necessitating the replacement of the pulse generator to restore normal pacing function.

Documentation should include the medical necessity for the procedure, the condition of the existing leads, details of the removal and replacement process, programming of the new device, and any complications encountered.

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