AAPC - Back to school
Results 1 to 5 of 5

Thread: 33223 revision of pocket

  1. #1

    Default 33223 revision of pocket

    AAPC: Back to School
    Hello All looking for some help with this code 33223.

    Doctor performed BIV ICD upgrade so I used 33240 &33241. Now he also did pocket revision which I want to use 33223 but all the CCI edits say it is included. The old pocket was in left pectoral and note states that patient was so thin that the new pocket had to be relocated to submuscular pocket. Do you think it is appropriate to use the 33223??

    Any advice would be appreciated .

  2. #2
    Join Date
    Apr 2007
    Jackson, TN

    Default BiV Upgrade

    Can you clarify for me what was upgraded? Was this and ICD upgraded to a BiV- ICD ? or a PPM upgrade to a BiV-ICD?

    Did you bill the appropriate 33224 or 33225 for the BiV lead? Both of these codes include revision of pocket, removal, insertion, and/or replacement of the generator.

    If this was a PPM upgrade to a BiV-ICD - 33233, 33225, 33240

    If this was an BiV-ICD upgrade to a previously placed ICD and generator- 33224

    Hope this helps!
    C. Weaver, CPC, CCC

  3. #3


    Yes it BIV-ICD upgrade to previous placed ICD w epicardial electrode

    So I should use 33224- 33202? & 33240 33241
    Last edited by Coder708; 12-04-2009 at 02:36 PM.

  4. #4
    Join Date
    Apr 2007
    Jackson, TN


    Ok I think I got. Sorry for the confusion. I would bill.

    33225- for the BiV upgrade
    33240- for the insertion of new generator
    33241- for the generator removal

    As for the 33223 , that is a tricky one. I see the 33222 specifically states relocation but only for the PPM and the 33223 only states revision.

    Also the edits do show 33241 and 33223 to be mutually exclusive, and the 33240 and 33223 to be bundled. It does state that unbundling is allowed with the appropriate modifier. You could try to bill the 33223 with a -59 modifier. I do not know for certain it will pay. I have never billed this code combination.

    If you did an epicardial electode I am honestly unsure what to bill... I just caught that you stated epicardial, we have never placed those... attempting it I would try 33224,33202 ( the 33240, and 33241 are included in the 33224 description)
    C. Weaver, CPC, CCC

  5. #5
    Join Date
    Apr 2007
    Richardson, TX


    C. Weaver

    Can I find what you said, "If this was an BiV-ICD upgrade to a previously placed ICD and generator- 33224" in writing by chance? I have a coder continually arguing with me because they they it should be 33240, 33241 and 33225. I thought you were to only use 33225 if the patient has NO PREVIOUS ICD - which is not our case. We are upgrading and 33224 includes revision, insertion and removal of generator.

    Not sure you'll see this. I realize its an 'old' post. I pray you do!

    Thanks in advance!
    Julie Graham, BA, CPC, CCC

Similar Threads

  1. pocket revision
    By Tmatthews in forum Cardiology
    Replies: 2
    Last Post: 08-29-2015, 03:49 PM
  2. Pm pocket revision
    By rebec26@juno.com in forum Cardiology
    Replies: 1
    Last Post: 05-21-2015, 11:49 PM
  3. Pocket revision...
    By jwhite2637 in forum Cardiology
    Replies: 4
    Last Post: 08-14-2014, 11:37 AM
  4. Pocket revision
    By HEMINGWAYT in forum Cardiology
    Replies: 0
    Last Post: 03-21-2013, 12:57 PM
  5. Pocket Revision/Debridement???
    By billiek in forum Cardiology
    Replies: 0
    Last Post: 10-21-2008, 10:30 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.