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33229 vs 33228
Question:
Patient has tachy-brady syndrome with complete heart block post AV node ablation. When the biventricular PPM was originally implanted in 2013 the atrial port was plugged. The biventricular PPM generator has reached end of service and was therefore replaced with a new generator; again only the RV and LV leads were attached to the new ST Jude CRT-P generator, model PM3222.
Seeing that CPT defines a multi-lead system as a pacemaker or implantable debrillator with pacing and sensing function in three or more chambers of the heart, is it appropriate to bill the 33229 due to the LV lead and CRT-P generator model used, or is it more appropriate to bill the 33228 due to patient only having two leads?
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