# Pacemaker generator replacement



## bforr (Nov 30, 2011)

I am in school studying coding, and we are working on a question in class. The question says that the patient is getting an additional electrode in the left ventricle, with a battery replacement. The guidelines say that with a battery replacement, you must code both the removal and the insertion of a pulse generator. For this question, we found code 33224, which says it includes both removal and repair. Can anyone shed some light on this for me?


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## twizzle (Nov 30, 2011)

*33224*



bforr said:


> I am in school studying coding, and we are working on a question in class. The question says that the patient is getting an additional electrode in the left ventricle, with a battery replacement. The guidelines say that with a battery replacement, you must code both the removal and the insertion of a pulse generator. For this question, we found code 33224, which says it includes both removal and repair. Can anyone shed some light on this for me?


33224 is the code for adding a left ventricular lead to an existing system. (I apologize if I give you incorrect information but I'm doing this without my CPT book). If you are billing a battery replacement it will be 33212 or 33213 depending on if it is a single or dual chamber pacer, and 33233 for removal of the old generator, and 33225 for placement of a LV lead. If the system is an ICD rather than a pacer it would be 33240 for a new ICD generator( single or dual is the same code) and 33241 for removal of the old generator, plus 33225 for the LV lead. Hope this helps.


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## twizzle (Dec 1, 2011)

*33224*

Of course, not having my CPT in front of me caused me to give you incorrect information. You can ignore what I posted previously. I rarely, if ever, bill 33224. I was thinking it was an add-on code like 33225. It would appear that 33224 does cover everything you mention as it includes generator replacement.


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## twizzle (Dec 1, 2011)

*33224 again*

33224 is very ambiguous in the CPT book. It does NOT include providing a new generator as 33225 is for a LV lead with a new generator. What I said initially is basically correct.
Sorry for the complete confusion.


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## bforr (Dec 1, 2011)

So, can we start over? Explain code 33224 to me.


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## twizzle (Dec 2, 2011)

33224 is for adding a LV lead when a pacer or ICD is already in place. Nothing else is added or removed. The descriptor is ambiguous in that it implies that a new generator may also be part of the code but that cannot be correct since 33225 is for a LV lead when a new pacer or ICD is placed.


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