# pacemaker lead extraction and explantation of generator



## trichards139 (Nov 14, 2017)

Can anyone tell me if you can bill 33233 for removal of generator along with 33235?  The generator and leads are removed without reinsertion.  The guidelines state "When reporting the system insertion or replacement codes, removal of a pulse generator (33233 or 33241) may be reported separately, when performed".  Am I correct that removal of transvenous electrode(s) (33234,33235 or 33244) includes explantation of the generator if it is not being replaced or upgraded?

Thank you


----------



## Misty Dawn (Nov 14, 2017)

trichards139 said:


> Can anyone tell me if you can bill 33233 for removal of generator along with 33235?  The generator and leads are removed without reinsertion.  The guidelines state "When reporting the system insertion or replacement codes, removal of a pulse generator (33233 or 33241) may be reported separately, when performed".  Am I correct that removal of transvenous electrode(s) (33234,33235 or 33244) includes explantation of the generator if it is not being replaced or upgraded?
> 
> Thank you




Depends on the type of system the pacemaker lead or leads are removed from. 33234 is used when a pacemaker lead is removed from a SINGLE lead system (atrial or ventricular) and 33235 is used when a single or multiple leads are removed from a DUAL lead system . CPT 33234 and 33235 do not included the removal of the generator and if removed is coded separately with 33233.

33244 is for the removal single or dual defibrillator electrode(s). If the ICD generator is also removed 33241 would be reported additionally to the lead removal codes.


----------



## trichards139 (Nov 15, 2017)

Thank you so very much for the quick response.  I appreciate the clarification!!


----------



## twizzle (Nov 15, 2017)

Misty Dawn said:


> Depends on the type of system the pacemaker lead or leads are removed from. 33234 is used when a pacemaker lead is removed from a SINGLE lead system (atrial or ventricular) and 33235 is used when a single or multiple leads are removed from a DUAL lead system . CPT 33234 and 33235 do not included the removal of the generator and if removed is coded separately with 33233.
> 
> 33244 is for the removal single or dual defibrillator electrode(s). If the ICD generator is also removed 33241 would be reported additionally to the lead removal codes.



Yes, I agree with Misty although I always wondered why there were different codes for removal of lead(s) from a single or dual lead system when the coding should really be based on how many leads were removed.


----------

