without reading the notes for each visit - I'd have to assume that the reason the 33213 (alone) is being coded/billed - is because the insertion/generator 33213 service and the insertion/lead service 33202/33203 were not done by the same physician/same session;(as the note states they have to be in order to be billed together)
Perhaps the the epicardial lead placement was done by a different physician?
but, again, we'd need to see the documentation to be certain.
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