Cardiology Coding Alert
33222 and 33223 Emphasize 'Relocation' for Cardiac Device Pockets as of January 1
Consider I&D codes when revision is performed.
If you’ve ever struggled with when to use revision codes for cardiac device pockets, you may be pleased to see “revision” deleted from codes 33222 and 33223 in 2014.
Review Changes to the Code Definitions
CPT® 2014, effective January 1, clarifies the definitions of cardiac device skin pocket codes by removing the term “revision” and focusing specifically on “relocation.” The updated code definitions remove the crossed out text and add the underlined text:
Benefit: The term “revision” has caused a lot of confusion over the years as coders tried to determine which services qualified as revision. The 2014 change makes it clear that the code only applies when the physician relocates the skin pocket.
Follow the Rules for Relocation
The pocket relocation codes include all work performed on the existing pocket, including hematoma or abscess incision and drainage (I&D), and creation of the new pocket, according to CPT® 2014 guidelines. Notes under 33222 and 33223 tell you not to report those codes with these I&D, debridement, and repair codes:
CPT® guidelines also state that you may report pocket relocation separately when the physician performs it as part of removing an old generator and replacing it with a new one.
Look Elsewhere for True Revision Services
Updated guidelines instruct that if the physician performs skin pocket revision with hematoma I&D or complex infection, then you should report the appropriate I&D or debridement code: 10140, 10180, 11042-11047.
Keep in mind that pocket revision is included in pacemaker and cardioverter-defibrillator codes 33206-33249 and 33262-33264.
Revision or relocationRelocation of skin pocket for pacemakerRevisionRelocation of skin pocket for cardioverter-defibrillator.
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