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Lead repositioning 33226

  1. Default Lead repositioning 33226
    Medical Coding Books
    Please advise.....edits state that repositioning of the left ventricular lead (33226) includes replacement of generator. C1882 Cardioverter-defibrillator, other than single or dual chamber (implantable) supply requires one of the following procedure codes 33224, 33240, or 33249. However, I receive encoder and Craneware edits stating that 33226 cannot be coded with the replacement of generator(old replaced with new). The existing left ventricular lead was reposition and the existing generator was replaced with a new one (C1882). Thank you for your help!

  2. #2
    Greater Orlando
    Default Don't try to unbundle
    CPT 33226 reads Reposition of previously implanted cardiac venous system (left ventricular) electrode (including removal, insertion, and/or replacement of existing generator)

    Since this procedure includes the replacement, do not report 33224, 33240, or 33249 as any one of these represents unbunding; your software is trying to warn you of the error.

    I believe that you need to only report CPT 33226 and the HCPCS C1882 for the replacement generator.
    Ron McKenzie, CPC-A
    Greater Orlando FL Chapter

  3. Default
    I agree that only 33226 and the device charge is needed, but the account does not pass edits because the device charge does not appear to be linked to 33226 and requires a placement code for the generator. So, do you think the error is in the actual edits? Craneware also does not link the device code to 33226 and would require another code for the generator insertion. Our Billing department is insisting the edits are correct and that another CPT code is required. I'll keep looking for supporting documentation. Thank you for your help.

  4. #4
    Greater Orlando
    Default 2011 CPT or 2012 CPT?
    A question I should have asked in the beginning, are you using 2011 or 2012 CPT?

    I checked with a colleague and she suggested looking at 33227 and/or 33262, if using 2012 CPTs; both are new in 2012.

    According to CPT 2012, 33226 was revised, however, when I compare it with CPT 2010's 33226, I see no differences in the wording of the procedures.

    Ron McKenzie, CPC-A
    Greater Orlando FL Chapter

  5. #5
    upper saddle river,nj
    Default 33263-removal of pacing cardio-defib
    I have a question regarding this new code,33263 (removal of pacing cardio-defibrillator), my provider wants to bill procedure code 33263 with procedure code 33240 (insertion of pacing cardio-defibrillator). CCI edits says that we can't bill these two codes together because they are bundled. Should 33263 only be billed alone because it includes the removal with the replacement?

    Mary Winfield, CPC

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