Ask Dr. Z

Would we report codes 33238, 33025, and 33202 for the following case? "Chest and abdomen prepped. The incision was 4 cm in length. The fascia and subcutaneous tissue were entered with electrocautery, obtaining hemostasis simultaneously. The pericardium was identified and entered. A small amount of venous blood was recovered. The pacemaker pocket was opened. At several points during the procedure the patient had periods of asystole. As a result, we placed a temporary pacemaker and continued pacing the patient. An epicardial lead was inserted and passed. We tunneled to the subclavicular fossa that was opened. The transvenous right ventricular lead was removed and sent to pathology. The epicardial lead was connected to the pacemaker. This was placed as DDIR 80/100 with a right atrial of 3.5 volts at 0.8 seconds, and the right ventricular 3.5 volts at 0.4 seconds. The epicardial lead was anchored to the pectoralis muscle with 2-0 ethibonds, and device was placed back into the pocket anchored to the pectoralis major muscle."