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Bi-V ICD Upgrade, lead removal, CS lead insertion, RA/RV lead remaining

Date: Mar 13, 2023

Question:

If a dual chamber ICD is upgraded to a biventricular ICD, CS lead inserted, and an old capped RV lead removed, how would this be reported? The patient has a functioning RV lead and RA lead (which were left in), and a capped RV lead that was removed. Our coding software does not offer a choice for lead removal without lead replacement. This assumes leads were replaced, which is not the case, and leads us to replacement codes. CPT instruction states 33244 can be used with 33264. Which coding group is correct in this case: 33249, 33225, 33241, and 33244? Or 33264, 33225, and 33244?

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