# Cpt 33210 then two days later 33208..



## daniel

Hopefully I can explain this right.

If your physician does CPT 33210  Single chamber Pacemaker Insertion of right ventricular apex.

Then two days laters does CPT 33208, Insertion of dual chamber pacemaker. Is common to bill CPT 33215 for the repositioning of the previously implanted transvenous pacemaker  electrode . Or would this be inclusive.

Curious to know when CPT 33208 and CPT 33215 would be used during the same session.

Thanks
Daniel,CPC


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## dphillips

33210 is a temporary pacemaker. If you bill a 33208(permanent atrial and venticular pacemaker) within 72 hours of the temporary, you will lose the temporary. The payor will recoup or ask for a refund for the 33210 if they have paid it. 33215 is repositioning of previously implanted pacemaker or ICD, not replacing it. Hope this helps.

Dawn, CPC, CCC


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## daniel

To follow up to this.

If your physician inserts a Temp Pacemaker CPT 33210.

Then comes back a day later and decides the patient needs a Dual-Chamber pacemaker CPT 33208. And removes the Temp pacemaker.

Can you charge for the removal of the temp pacemaker. Or is it inclusive to CPT 33208.

??????


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## Jess1125

There isn't a code for the removal of a temporary pacemaker. 

I think (don't quote me) that the work of removing it is included in the temporary pacemaker insertion code because of the fact that the code description says it is TEMPORARY. Since it is temporary it is assumed that it will be removed as well so I think the work of that is included in the code as well. I had read that somewhere I believe.

Jessica CPC, CCC


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## lehrra

I have a claim denied by Medicare with the following and am not sure what i have done wrong:
7/29/10   33217  replaceed atrial lead in perm pacemaker
8/14/10   33210  put in a temporary pacemaker (permanent was removed by another cardiologist NOT in my group)
8/18/10   33208  put in a permanent pacemaker

I know theres a 72 hour window on getting a perm and temp paid but I'm outside of this timeframe.  Medicare doesnt want to pay for the 33210 without a 58 or 79...its neither.  Can anyone shed some light???

Thanks!


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## dphillips

I would call Medicare and argue the point, since the temp is outside the window of the permanent. Then I would file for redetermination with all of my documentation to back it up.

Dawn CPC, CCC


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