Summary & Overview
CPT 33279: Phrenic Nerve Stimulator Lead Removal
CPT code 33279 represents the surgical removal of stimulation or sensing leads from a phrenic nerve stimulator system and encompasses vessel catheterization, imaging guidance, and any interrogation or programming performed during the procedure. This code is clinically significant due to the increasing use of implantable neuromodulation devices for refractory conditions and the procedural complexity involved in lead explantation, which can affect resource use, site-of-service decisions, and payer coverage determinations.
Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise national overview of clinical context and coding intent, typical sites of service, and what to expect in terms of payer coverage patterns. The publication highlights benchmarks and reimbursement considerations relevant to facility and professional billing for lead removal procedures, and summarizes common documentation elements and clinical scenarios that drive coding and billing choices.
The content provides a practical reference for revenue cycle, compliance, and clinical teams seeking clarity on when 33279 is reported, its bundled components, and implications for preauthorization and site selection. Data not available in the input will be explicitly noted in the detailed sections that follow.
Billing Code Overview
CPT code 33279 describes removal of stimulation or sensing leads for a phrenic nerve stimulator system. The code includes all necessary vessel catheterization, imaging guidance, and device interrogation and programming if performed.
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Service type: Lead removal/explantation of a phrenic nerve stimulator system
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Typical site of service: Hospital outpatient department or ambulatory surgery center where device removal and intraoperative imaging or programming can be performed
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with an implanted phrenic nerve stimulator system who presents for elective removal of stimulation or sensing leads due to lead malfunction, infection, pain at the implant site, or end of therapy. The patient has been evaluated in clinic; preoperative assessment includes review of device interrogation records, chest imaging when indicated, and assessment of infection or wound status. On the day of the procedure, the patient is brought to a cardiac electrophysiology or hybrid interventional suite. Under monitored anesthesia care or general anesthesia depending on patient comorbidity and procedural complexity, the provider performs surgical exposure of the lead pocket and lead tract. Lead extraction techniques appropriate to the device and lead age are used, including manual traction, locking stylets, or extraction sheaths as needed. The code includes any necessary vascular catheterization and imaging guidance (fluoroscopy) and interrogation/programming of the device before and after lead removal. Post-procedure workflow includes hemostasis, wound closure, postoperative device interrogation if any remaining components are present, and discharge planning with wound and infection precautions. Typical sites of service are the hospital inpatient or outpatient operating room, ambulatory surgical center, or cardiac catheterization lab, depending on clinical indication and patient status.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier specified | Use when no specific modifier applies and payer requires default coding. |