Something like this (from acadx.com):
(defun ax:ChangeBitmap (mnuGroup tbrName btnName bitmap)
(vl-load-com)
(vla-setbitmaps
(vla-item
(vla-item
(vla-get-toolbars
(vla-item (vla-get-menugroups (vlax-get-acad-object))
mnuGroup
)
)
tbrName
)
btnName
)
bitmap
bitmap
)
(princ)
)
Purpose
Changes the button top for the specified toolbar button
Arguments
The name of the menu group, the name of the toolbar, the name of the toolbar button and the bitmap to use
Example
(ax:ChangeBitmap "acad" "dimension" "linear dimension" "test.bmp")
Notes
If the bitmap is not in the AutoCAD search path, you must specify the full path to file