# Upgrade to CRT-P



## denisek1028 (Apr 19, 2016)

Patient undergoes upgrade from dual chamber pacemaker to CRT-P.  

Provider performs removal of dual chamber pacemaker, implants new right atrial pacing lead and implants new CRT-P generator.  Patient has had a recently placed left ventricular pacing lead done at a prior procedure.  

Would I use 33233 for the removal of the pacer and 33206 for placement of the CRT-P?  

Any help would be appreciated.

Thanks!


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## camillecoder@hotmail.com (Apr 22, 2016)

33229  33225


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## camillecoder@hotmail.com (Apr 22, 2016)

*EP Resource Link*

Boston Scientific has a good resource booklet.  I printed pages 19 - 53 and keep them in a binder on my desk.

https://www.bostonscientific.com/co...ng and Coding Guide for Rhythm Management.pdf


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## Misty Dawn (Apr 25, 2016)

CPT 33229 is used only if the generator is replaced and no new leads.  This would not be correct for the above case because a new RA lead was also placed.  CPT 33225 is for LV lead insertion only-from the sound of above the LV placed prior to or by another provider and would not be coded here.  It sounds like that the generator was removed and replaced and a new RA lead was placed.  This would be coded with: 33206, 33233.51.  Your initial coding in first post denisek1028 is correct.  

Misty Sebert CPC, CCC, CCVTC


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## denisek1028 (Apr 26, 2016)

Misty Dawn said:


> CPT 33229 is used only if the generator is replaced and no new leads.  This would not be correct for the above case because a new RA lead was also placed.  CPT 33225 is for LV lead insertion only-from the sound of above the LV placed prior to or by another provider and would not be coded here.  It sounds like that the generator was removed and replaced and a new RA lead was placed.  This would be coded with: 33206, 33233.51.  Your initial coding in first post denisek1028 is correct.
> 
> Misty Sebert CPC, CCC, CCVTC



Thank you Misty!!  It is always these unusual circumstances that throw me for a loop!


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