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Code deleted, see 33285, 33286

Official Description

Implantation of patient-activated cardiac event recorder

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The implantation of a patient-activated cardiac event recorder, commonly known as an implantable loop recorder (ILR), is a medical procedure designed to monitor and record the heart's rhythm. This device is particularly useful for patients experiencing unexplained cardiac symptoms such as palpitations, dizziness, or fainting spells. The recorder is inserted into a subcutaneous pocket in the chest, typically in the left pectoral region, allowing for discreet and continuous monitoring of the heart's electrical activity. The device is equipped with sensing electrodes that capture heart rhythm data for several minutes after the patient activates it in response to symptoms. This activation is done using a hand-held device, which allows the patient to permanently record significant events in the device's memory. Additionally, the cardiac event recorder can be programmed to automatically record events based on preset parameters. Prior to the implantation, the device undergoes testing and programming to ensure it is set to capture the appropriate number of patient-activated and auto-activated events, as well as to determine the optimal sensitivity for accurate readings. The procedure concludes with the device being secured in place and the incision closed, followed by patient education on how to use the device effectively.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The patient-activated cardiac event recorder is indicated for patients who experience unexplained cardiac symptoms that may require further investigation. These symptoms include:

  • Heart Palpitations - Episodes of rapid or irregular heartbeats that may be concerning to the patient.
  • Dizziness - A sensation of lightheadedness or unsteadiness that may be related to cardiac events.
  • Fainting Spells - Instances of loss of consciousness that could be linked to abnormal heart rhythms.

2. Procedure

The procedure for implanting a patient-activated cardiac event recorder involves several critical steps to ensure proper placement and functionality of the device.

  • Step 1: Pre-implantation Testing and Programming - Before the implantation, the device is thoroughly tested and programmed. The physician selects the number of patient-activated and auto-activated events that the device will store. Additionally, the electrocardiogram (ECG) storage capacity is set, and parameters for recording auto-activated events are established. The optimal sensitivity settings for the device are also determined and programmed to ensure accurate monitoring.
  • Step 2: Incision and Pocket Creation - An incision is made in the skin, typically located in the left pectoral region. This incision allows access to create a subcutaneous pocket where the device will be placed. The pocket is fashioned to securely hold the device in place.
  • Step 3: Device Placement - The patient-activated cardiac event recorder is carefully placed into the subcutaneous pocket. It is then sutured to the underlying tissue to ensure stability and prevent movement.
  • Step 4: Incision Closure - After the device is securely in place, the incision is closed over the device. This step is crucial for protecting the device and promoting healing.
  • Step 5: Device Testing - Once the incision is closed, the device is tested to verify that it is functioning properly. This ensures that the device is ready to monitor and record heart rhythms as intended.
  • Step 6: Patient Instruction - Finally, the patient is instructed on how to use the device, including how to activate it during episodes of symptoms and how to interpret the recordings.

3. Post-Procedure

After the implantation of the patient-activated cardiac event recorder, patients can expect a recovery period that may involve some discomfort at the incision site. It is important for patients to follow any post-operative care instructions provided by their physician, which may include keeping the incision clean and dry, monitoring for signs of infection, and avoiding strenuous activities for a specified period. Patients should also be aware of how to operate the device and when to activate it in response to symptoms. Regular follow-up appointments may be scheduled to assess the device's functionality and to review recorded data.

Short Descr IMPLANT PAT-ACTIVE HT RECORD
Medium Descr IMPLANTATION PT-ACTIVATED CARDIAC EVENT RECORDER
Long Descr Implantation of patient-activated cardiac event recorder
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P2F - Major procedure, cardiovascular-Other
MUE Not applicable/unspecified.
CCS Clinical Classification 62 - Other diagnostic cardiovascular procedures
Date
Action
Notes
2019-01-01 Deleted Code deleted, see 33285, 33286
2017-01-01 Changed Moderate (Conscious) Sedation flag removed. See new Moderate Sedation category.
2013-01-01 Changed Guideline information changed per AMA corrections document. Added code 93299.
2000-01-01 Added First appearance in code book in 2000.
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