2025 CPT code 33263
(Active) Effective Date: N/A Revision Date: N/A Surgery - Cardiovascular System Procedures Surgery Feed
Removal and replacement of an implantable cardioverter-defibrillator (ICD) pulse generator; dual-lead system.
Modifiers 26 (professional component), 51 (multiple procedures), and 59 (distinct procedural service) may be applicable depending on the clinical scenario and other procedures performed on the same day.
Medical necessity is established by documentation showing the need for generator replacement due to depleted battery, malfunction, or other clinical indications affecting the device's ability to provide appropriate therapy.The physician's documentation must clearly justify the need for the procedure.
The procedure requires surgical expertise in cardiovascular procedures, including knowledge of ICD systems and lead management.Pre-operative planning, including imaging review, and post-operative device programming and follow-up care are crucial.
In simple words: The doctor removes the old heart defibrillator battery pack and puts in a new one. The wires to the heart stay in place.
This CPT code encompasses the surgical removal of an existing implantable cardioverter-defibrillator (ICD) pulse generator and its replacement with a new one.The procedure involves disconnecting the existing generator from the dual leads already in place within the patient's heart, removing the old generator, and implanting a new one while maintaining the connection to the existing leads.This is usually done when the generator's battery is depleted or the device malfunctions.
Example 1: A patient with an ICD implanted five years ago presents with a depleted generator battery.The existing dual-lead system functions correctly.Code 33263 is used to report the generator replacement., A patient experiences ICD malfunction due to a faulty generator.The existing dual-lead system is functional.The generator is replaced using code 33263., A patient requires ICD generator replacement after an infection at the implantation site.The existing dual-lead system is deemed functional and is reused during the generator replacement. Code 33263 is applied.
** This code should only be used when replacing the generator with existing dual leads.If leads are also replaced or added, other CPT codes should be used in conjunction with this one, potentially with modifier 51.Always refer to the latest CPT manual for the most up-to-date guidelines.
- Payment Status: Active
- Modifier TC rule: Modifier TC (technical component) is not applicable as this code represents the professional component of the procedure.
- Specialties:Cardiology, Cardiac Surgery, Electrophysiology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center