# Left Ventricular Lead Replacement?



## senpai_j (Sep 12, 2013)

A patient already has a bi-ventricular pacemaker. The physician discovers that the Left Ventricular Lead has become dislodged. When he performed the surgery, instead of just repositioning the lead, he removed it and put in a new one. The same pacemaker was put back in. 
I'm having trouble narrowing down CPT because the lead was replaced and not repaired or repositioned, and the patient was not getting an upgrade because he already has a bi-ventricular system. None of the CPT codes seem to accurately describe what was actually done. 

Can I get some guidance? Would I bill 33235 and 33216? Is 33226 a better choice because of the type of lead? 

Thanks,


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## sparker (Sep 13, 2013)

*Left Ventricular Lead Replacement*

You should code what the physician did: Remove LV lead, Insert new LV lead. The removal code will depend on what type of system the patient had: single chamber, dual chamber. 33234 Removal electrode single lead system (atrial or ventricular) or 33235 removal electrode dual lead system (atrial and ventricular). New lead would be 33216 Insertion of single transvenous electrode. 
33226 is a system code and would only be used for insertion of new system with LV lead.


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