February 2018 Q & A

Question: Single Lead Pacemaker Generator Change

1. Pacemaker generator change 2. Placement of a new lead in the right ventricle 3. Capping and abandonment of old lead. When the existing right ventricular lead has been capped and abandoned and new lead is advanced into the right ventricular apex using a combination of straight and custom-formed stylettes onto new pacemaker generator, (pulse generator was also changed), should this procedure be coded as 33212, 33216, 33233? Or 33227 with 33212 and 33216, and is fluoroscopy always included in a pacemaker procedure?


Fluoroscopy is bundled into all pacemaker and defibrillator procedures. When both a new lead and a new generator are placed, it is coded as a new system insertion…in this case it would be 33207 for the RV lead and new generator. You also report 33233 for removal of the existing generator and no code for capping the existing lead.