Summary & Overview
CPT 33262: Implantable Defibrillator Pulse Generator Replacement, Single Chamber
Headline: CPT code 33262: Replacement of an Implantable Defibrillator Pulse Generator for Single-Chamber Systems
Lead: CPT code 33262 identifies the surgical service of removing a previously implanted implantable cardioverter-defibrillator (ICD) pulse generator and replacing it with a new generator for a system with a single-chamber lead. This procedure is clinically important for addressing device malfunction, battery depletion, and infection, and it is commonly performed in operative settings with cardiac electrophysiology support.
CPT code 33262 represents an ICD generator exchange for single-chamber lead systems and matters nationally because ICDs play a critical role in preventing sudden cardiac death; timely, appropriate replacement of pulse generators maintains patient safety and device functionality. Key payers typically involved in coverage and reimbursement decisions include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will learn the clinical context and service setting associated with this code, common payer coverage considerations, and where to find benchmarks and policy updates relevant to ICD generator replacement. The publication provides concise benchmarks, coding guidance context, and policy highlights to inform billing, compliance, and clinical teams about proper use of CPT code 33262 in national practice.
Billing Code Overview
CPT code 33262 describes removal of a previously implanted implantable cardioverter-defibrillator (ICD) pulse generator and replacement with a new pulse generator when the system includes a lead to a single chamber of the heart. The procedure addresses malfunctioning pulse generators or situations such as device infection that require component exchange.
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Service type: Pulse generator removal and replacement (ICD generator exchange) for a single-chamber lead system
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Typical site of service: Hospital operating room or cardiac electrophysiology procedure suite, and may occur in ambulatory surgical centers when appropriate
Clinical & Coding Specifications
Clinical Context
A 72-year-old male with ischemic cardiomyopathy and a previously implanted single‑chamber implantable cardioverter‑defibrillator (ICD) presents for replacement of the pulse generator due to battery depletion and device elective replacement indicator. The patient has a single right ventricular lead in place with stable lead parameters on interrogation. Preoperative workflow includes device interrogation by cardiac electrophysiology staff, assessment of anticoagulation status, informed consent, chest radiograph review, and baseline labs if indicated. In the operating/procedure suite the patient is positioned supine, local anesthesia with conscious sedation administered per institutional protocol, the generator pocket is opened, the old generator is disconnected and removed from the header without extracting the lead, the new compatible single‑chamber ICD generator is connected to the existing lead, sensing and defibrillation thresholds are tested as indicated, the pocket is irrigated and closed, and postprocedure device interrogation and chest radiograph are obtained prior to discharge or observation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No specific modifier (placeholder) | Rarely appended; vendor/proprietary — typically not used on claims |
11 |