Basics about CPT code 33206, 33207 & 33208
A permanent cardiac pacemaker system is inserted or replaced, including subcutaneous insertion of the pulse generator and transvenous placement of the endocardial electrodes (leads). Cardiac pacemakers deliver an electronic impulse to the Heart at a programmed rate to help the heart maintain a normal heart rhythm. Permanent pacemaker systems may be single chamber (atrial or ventricular) or dual chamber (atrial and ventricular) systems and the leads may be placed either on the surface of the heart (epicardial) or within the heart chamber (endocardial). An incision is made in the skin of the upper chest and the cephalic, subclavian or jugular vein exposed. A sheath is inserted into the selected vessel and the pacemaker wire is advanced under radiological guidance into the selected heart chamber. The lead is positioned against the wall of the heart chamber. If a dual chamber device is required, the second wire is threaded to the selected chamber and the lead positioned against the heart wall. The leads are then tested to verify that they are functioning properly. Next, an incision is made in the skin, typically in the left pectoral region, and a subcutaneous pocket fashioned. The lead(s) is(are) then connected to the pulse generator and the pulse generator is tested. Once it has been determined that the leads and generator are working as desired, the pulse generator is placed into the pocket, sutured to underlying tissue, and the pocket is closed.
Code 33206 is used for a single chamber pacemaker with the lead in the right atrium and 33207 for a single chamber pacemaker with the lead in the right ventricle. Code 33208 is used for a dual-chamber pacemaker with leads in both the right atrium and right ventricle.
Code description of CPT code 33206, 33207 & 33208
33206 - Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial
33207 - Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); ventricular
33208 - Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial and ventricular
Do and Don’t with CPT code 33206, 33207 & 33208
Do not report 33206-33208 in conjunction with 33227-33229
Do not report 33206, 33207, 33208 in conjunction with 33216, 33217
Codes 33026-33208 include subcutaneous insertion of the pulse generator and transvenous placement of electrode[s]
For removal and replacement of pacemaker pulse generator and transvenous electrode(s), use 33233 in conjunction with either 33234 or 33235 and 33206-33208
ICD-10-CM Codes that support Medical Necessity
I09.81 - Rheumatic heart failure
I11.0 - Hypertensive heart disease with heart failure
I13.0 - Hypertensive heart and Chronic Kidney Disease with heart failure and stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
I13.2 - Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease
I50.20 - I50.9
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