2025 CPT code 33203
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Surgery Feed
Insertion of epicardial electrode(s) using an endoscopic approach (e.g., thoracoscopy, pericardioscopy).
Modifiers may be applicable depending on the circumstances of the procedure. Consult the CPT codebook for appropriate modifier usage.
Medical necessity is established by the patient's clinical condition and the need for epicardial lead placement to improve cardiac pacing or defibrillation.This may be documented via the patient's history, physical examination findings, electrocardiogram (ECG), and other diagnostic tests. The necessity of the endoscopic approach should also be documented.
The physician's responsibilities include patient preparation, anesthesia administration (if applicable), creating a small chest incision, inserting and securing the epicardial electrode(s) under endoscopic guidance, closing the incision, and dressing the wound.Preoperative and postoperative care may also be included, depending on the specific circumstances and billing practices.
In simple words: The doctor inserts small wires or electrodes onto the outside of the heart using a tiny camera and thin instruments inserted through a small chest incision. This helps the heart beat regularly.
This CPT code encompasses the insertion of one or more epicardial electrodes onto the external surface of the heart via an endoscopic technique, such as thoracoscopy or pericardioscopy.The procedure involves creating a small incision in the chest, advancing the electrode(s) into the pleural space under endoscopic guidance, and securing them to the pericardial surface. The incision is then closed, and the wound is dressed.When performed concurrently with generator insertion by the same physician, this code should be reported in conjunction with codes 33212, 33213, 33221, 33230, 33231, or 33240.
Example 1: A patient presents with a history of heart failure and requires an implantable cardioverter-defibrillator (ICD).Due to anatomical considerations, the cardiothoracic surgeon decides to place the electrodes epicardially using a minimally invasive thoracoscopic approach. Code 33203 is reported for the endoscopic placement of the epicardial electrodes., During a cardiac surgery, the surgeon finds it necessary to place additional epicardial electrodes for optimal pacing.Using a thoracoscope, these electrodes are inserted and secured. Code 33203 is reported in addition to the other codes for the primary cardiac procedure., A patient with a history of recurrent ventricular tachycardia undergoes a procedure to implant a biventricular pacemaker. The cardiologist elects to use an epicardial approach for one of the leads to improve pacing efficiency and uses a pericardioscopic technique. Code 33203 is reported for the placement of the epicardial lead.
Comprehensive documentation should include the indication for epicardial lead placement, the type of endoscopic approach used (thoracoscopy or pericardioscopy), the number of electrodes inserted, operative notes detailing the technique employed, and postoperative recovery.
** This code should only be used when an endoscopic approach (thoracoscopy or pericardioscopy) is employed for epicardial lead placement.The use of an open thoracotomy necessitates the use of a different CPT code (33202).
- Payment Status: Active
- Specialties:Cardiothoracic Surgery, Cardiac Electrophysiology
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center