Cardiology Coding Alert

Question: After the patient was appropriately prepped and local anesthesia administered, my provider made an incision into the existing pocket in the subcutaneous tissue of the patient’s left upper chest to remove the cardiac rhythm monitor. They cut the sutures holding the device in place and removed the device from the pocket. Finally, they flushed the pocket with an antimicrobial solution and closed the incision. What code should I report for this service?

Georgia Subscriber

Answer: You should report 33286 (Removal, subcutaneous cardiac rhythm monitor).

Subcutaneous cardiac rhythm monitor defined: Also known as a cardiac event recorder or implantable/insertable loop recorder (ILR), a subcutaneous cardiac rhythm monitor, is a device that the cardiologist subcutaneously places to continuously record the electrocardiographic rhythm, per CPT^®. The subcutaneous cardiac rhythm monitor is triggered automatically by rapid, irregular, and/or slow heart rates or by the patient during a symptomatic episode. Your provider will place the subcutaneous cardiac rhythm monitor using a small parasternal incision, followed by insertion of the monitor into a small subcutaneous pre-pectoral pocket, and finally, they will close the incision.