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Medicare Advantage Prior Authorization
Automatic Implanted Cardioverter Defibrillator (AICD)

last updated 04/23/2012 garcarl

33230 Insertion of pacing cardioverter-defibrillator pulse generator only; with existing dual leads
33231 Insertion of pacing cardioverter-defibrillator pulse generator only; with existing multiple leads
33240 Insertion of single or dual chanber pacing cardioverter-defibrillator pulse generator
33249 Insertion or repositioning of electrode lead(s) for single or dual chamber pacing cardioverter-defibrillator and insertion of pulse generator
33262 Removal of pacing cardioverter-defibrillator pulse generator with replacement of pacing cardioverter-defibrillator pulse generator; single lead system
33263 Removal of pacing cardioverter-defibrillator pulse generator with replacement of pacing cardioverter-defibrillator pulse generator; dual lead system
33264 Removal of pacing cardioverter-defibrillator pulse generator with replacement of pacing cardioverter-defibrillator pulse generator; multiple lead system
C1721 Cardiovert-defibrillator, dual chamber (implantable)
C1722 Cardiovert-defibrillator, single chamber (implantable)
C1777 Lead, cardioverter-defibrillator, endocardial single coil (implantable)
C1882 Cardioverter-defibrillator, other than single or dual chamber (implantable)
C1895 Lead, cardioverter-defibrillator, endocardial dual coil (implantable)
C1896 Lead, cardioverter-defibrillator, other than endocardial single or dual coil (implantable)
C1898 Lead, pacemaker, other than transvenous VDD single pass
C1899 Lead, pacemaker/cardioverter-defibrillator combination (implantable)

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