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Inside Out Technique Active Fixation "Temp" Lead

Date: Oct 11, 2023

Question:

Would this be CPT 33216 or unlisted 33999? A 6 French sheath was placed in the right common femoral vein under ultrasound guidance. A 5 French BER II catheter was advanced under fluoroscopic guidance to the superior vena cava, and then to the stump of the occluded right internal jugular vein. The catheter was exchanged over a guidewire for an 8.5 French transseptal dilator. A BRK needle was then advanced to the level of the clavicle and oriented anteriorly. Inside-out puncture was performed using a sharpened 0.018 in guidewire. A peel-away sheath was placed. A Medtronic pacing lead was advanced to the RV apical septum and the fixation screw was extended. Sensing and pacing parameters were measured. The sheath was removed and the lead was anchored with silk suture. A pulse generator was connected and anchored. What is this was used for lead placement in a DC PPM insertion (33208)?

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