CPT® Code 33202

The procedure described by CPT® Code 33202 involves the insertion of epicardial electrode(s) through an open incision, which may be performed via various surgical approaches such as thoracotomy, median sternotomy, or subxiphoid approach. Epicardial electrodes, also referred to as leads, are specialized devices that are placed on the outer surface of the heart muscle to facilitate electrical stimulation. This procedure is typically indicated for patients requiring cardiac pacing or defibrillation support, where the electrodes are strategically positioned to ensure optimal functionality based on the type of device being utilized. For instance, a single chamber permanent pacemaker necessitates the placement of one electrode either in the atrium or ventricle, while a dual chamber device requires one electrode in each of these heart chambers. The surgical process involves opening the chest cavity to expose the heart, allowing for precise placement and secure attachment of the electrodes to the heart muscle. Following the positioning of the leads, a subcutaneous tunnel is created to connect the electrodes to the device generator, which is usually implanted beneath the skin in the chest area or upper abdomen. The leads are then tested for proper function before the surgical incision is closed. It is important to note that this code specifically pertains to the insertion of the epicardial electrode lead(s) and does not include the generator itself, which is reported separately under different coding guidelines.