Cardiology Coding Alert

Question: When two electrodes are repositioned (atrial and ventricular), same session, would you code 33215 once or twice?

Codify Member

Answer: You may report 33215 (Repositioning of previously implanted transvenous pacemaker or pacing cardioverter-defibrillator [right atrial or right ventricular] electrode) twice. If you report them as two line items, append modifier 59 (Distinct procedural service) to the second 33215 to indicate that two electrodes were repositioned.

Rationale: The definition specifies the code is for atrial "or" ventricular electrode repositioning. The "or" suggests one unit covers one heart chamber. If the code definition said right atrial "and" right ventricular, then you would only use one unit to report repositioning in both.

Also, CMS gives the code a medically unlikely edit (MUE) of 2. That means you may report up to two units of the code on a single line if documentation supports doing so. Reporting more than 2 units would trigger an automatic denial of that line item.