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CPT code for Left Bundle lead with ICD Gen change

Date: Aug 31, 2022

Question:

What CPT code can I use to capture a left bundle lead with biventricular ICD generator upgrade, not a bundle of His lead? Code 33264 can be used to capture the generator change. Dual ICD generator upgrade with existing RA/RV leads and implant of LB lead with new biventricular ICD generator.

"The prior RA and RV leads were tested and found to have adequate capture and sensing function. A new lead was placed, the left axillary vein was accessed using the seldinger technique. Through a 7 French sheath and using a C315HIS preformed catheter a Medtronic 3830 lead was advanced to the RV septum in the area of the His bundle. A His bundle potential was mapped. The lead was advanced and moved slightly infereriorly. The lead was screwed into the septum, pacing from this lead did not produce a narrow QRS with iRBBB morphology. A number of sites on the septum were tried with a final site showing adequate pacing and sensing thresholds, a fairly narrow paced QRS and stim to peak LV activation of less than 80ms. BiV pacing from this site and the RV produced a very narrow QRS."

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