Did the Patient have a Pacemaker and then an upgrade to Bi-V ICD or a Dual ICD and upgraded to a Bi-V ICD?
If it was a dual pacemaker removed, LV lead inserted, new ICD generator, and DFT Testing: 33233, 33225, 33240, 93641-26, 71090-26.
If it was a ICD generator removed, LV lead inserted, new ICD generator, and DFT Testing: 33241, 33225, 33240, 93641-26, 71090-26.
33224 only is used when you don't replace the generator (you use the same exact generator)!
33249 can't be billed because you didn't insert a new lead with a generator (a new right atrial lead and/or new right ventricular).
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