2025 CPT code 33243
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Feed
Removal of single or dual chamber implantable defibrillator electrode(s) by thoracotomy.
Modifiers may be applicable to indicate specific circumstances of the procedure, such as increased procedural services (22), or other factors affecting the service provided.
Medical necessity is established when transvenous lead extraction is unsuccessful or contraindicated, and open surgical removal is necessary to address infection, lead malfunction, or other complications related to the ICD lead.
The surgeon prepares the patient and administers anesthesia. An incision is made over the existing device pocket, and the leads are disconnected from the generator.Next, a thoracotomy is performed to access the heart and the attached electrodes. Scar tissue around the leads is removed. Once the electrode is detached from the heart, the site is repaired. Bleeding is controlled, and the chest and device pocket incisions are closed with sutures.
In simple words: This procedure involves surgically removing wires connected to a heart defibrillator through an incision in the chest. This is done when less invasive removal methods are not possible.
This code describes a procedure where a surgeon performs a thoracotomy (incision into the chest wall) to remove an implantable defibrillator electrode(s).Implantable defibrillators (ICDs) are devices that monitor heart rhythms and deliver electrical shocks to correct life-threatening arrhythmias. They consist of a pulse generator and electrodes (leads). This code is specifically for the removal of the electrode(s) through an open chest approach and is used when transvenous removal is not feasible.
Example 1: A patient with an infected ICD lead requires removal of the lead via thoracotomy because transvenous extraction attempts were unsuccessful., A patient with a fractured ICD lead requires thoracotomy for lead removal due to the complexity of the lead extraction., A patient requires removal of an ICD lead after multiple unsuccessful transvenous extraction attempts, necessitating a thoracotomy approach.
Operative report detailing the thoracotomy, lead removal, and any complications. Pre-operative imaging and procedural documentation supporting the medical necessity of the thoracotomy approach.
- Specialties:Cardiothoracic Surgery, Cardiac Electrophysiology
- Place of Service:Inpatient Hospital