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33249 is for an ICD not a pacemaker. I presume you mean ICD because of the Dx you are giving.
You need to append modifier Q0 to 33249 and attach the clinical trial number(available on the MCR website somewhere). It begins with NCT000something...... can't remember exactly.
If you're unsure about the use of Q0 see my previous responses in the cardiology section of this forum.