Cardiology Coding Alert

Question: Were there any new 2019 CPT^® guidelines to go along with new codes 33274 and 33275?

North Dakota Subscriber

Answer: Yes. CPT^® 2019 added some new guidelines for new codes 33274 (Transcatheter insertion or replacement of permanent leadless pacemaker, right ventricular, including imaging guidance (eg, fluoroscopy, venous ultrasound, ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed) and 33275 (Transcatheter removal of permanent leadless pacemaker, right ventricular).

So, when you report 33274 and 33275, you should remember the following:

• Never report 33274 in conjunction with 33275.
• Never report 33274 or 33275 in conjunction with femoral venography code 75820; fluoroscopy codes 76000 or +77002; ultrasound guidance for vascular access code +76937; or right ventriculography code +93566.

You should not report 33274 or 33275 in conjunction with heart catherization codes 93451 or 93453; catheter placement codes 93456, 93457, 93460, or 93461; and codes 93530 (Right heart catheter­ization, for congenital cardiac anomalies) through 93533 (Combined right heart catheterization and transseptal left heart catheterization through existing septal opening, with or without retrograde left heart catheterization, for congenital cardiac anomalies) unless the cardiologist performed the complete right heart catheterization for indications distinct from the leadless pacemaker procedure.