2025 CPT code 33231
(Active) Effective Date: N/A Surgical Procedures on the Cardiovascular System - Cardiovascular System Surgery Feed
Insertion of implantable defibrillator pulse generator only; with existing multiple leads.
Modifiers may be applicable in certain circumstances, such as increased procedural services (modifier 22) or discontinued procedures (modifier 53).
Medical necessity for this procedure is established by the need to replace a non-functioning, infected, or nearly depleted pulse generator in a patient with an existing implantable defibrillator system with three or more leads.
The physician performs the procedure under sterile conditions, typically in an operating room or cardiac catheterization laboratory. The physician makes an incision to access the existing defibrillator pocket, removes the old pulse generator, connects the leads to the new pulse generator, tests the device, and then closes the incision. The physician also programs the new defibrillator according to the patient's specific needs.
In simple words: This procedure involves replacing the battery pack (pulse generator) of an implantable defibrillator under the skin, while leaving the existing wires (leads) in place.This is done when the battery needs to be changed, but the wires are still working fine. The new pulse generator is placed in the same pocket under the skin as the old one, or a new pocket may be created.
This procedure involves the insertion of a new implantable defibrillator pulse generator in a subcutaneous pocket, typically in the infraclavicular or abdominal region.The existing multiple leads (three or more) from the previous defibrillator system remain in place and are connected to the new pulse generator. This procedure is performed when the pulse generator needs to be replaced, but the leads are still functional.
Example 1: A patient with an existing implantable defibrillator with three leads experiences an elective replacement indicator (ERI) on their device, signifying that the battery is nearing the end of its life. The physician schedules the patient for a pulse generator replacement and performs code 33231., A patient's implantable defibrillator malfunctions, requiring replacement of the pulse generator. The patient has a dual-chamber ICD system plus a left ventricular lead. The physician replaces the generator using code 33231., A patient with an existing ICD system develops a pocket infection. After treating the infection, the physician decides to replace the generator and relocate the pocket to a new site. The physician reports the removal of the generator (33241), relocation of the pocket (33223), and insertion of the new generator with the existing multiple leads (33231).
Documentation should include the type of defibrillator implanted, the number and location of existing leads, the reason for pulse generator replacement, any complications encountered during the procedure, and the device's programming parameters.
- Revenue Code: P2E
- Payment Status: Active
- Specialties:Cardiac Electrophysiology, Cardiothoracic Surgery
- Place of Service:Ambulatory Surgical Center, Hospital Inpatient, Hospital Outpatient