C7538 Insrt vent pm w/l vent leadInsertion of new or replacement of permanent pacemaker with ventricular transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertion of implantable defibrillator or pacemaker pulse generator (e.g., for upgrade to dual chamber system)
C7538 appears in 4 coverage policies from Aetna, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT).
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Body Surface Potential Mapping (0705) | listed, no stance | Nov 24, 2025 | payer document |
| Aetna | Cardiac Resynchronization Therapy and Other Pacing/Defibrillator Treatments for Heart Failure (0610) | covered if criteria are met | Sep 18, 2026 | payer document |
| Aetna | Cardioverter-Defibrillators (0585) | covered if criteria are met | Apr 22, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Biventricular Pacemakers (Cardiac Resynchronization Therapy) for the Treatment of Heart Failure (MED202.054) CPT Codes 33202, 33203, 33207, 33208, 33211, 33213, 33214, 33217, 33220, | listed, no stance | Oct 1, 2026 | payer document |
From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.