Ask Dr. Z

If the physician attempts to remove the generator due to possible infection but then changes his mind and puts it right back, can we use the remove/replace code (33228) even though there was no new generator placed, or would this be unlisted? "Given the extremely poor wound healing of this incision I suspected that the pocket was potentially infected as well and considered removing the pacemaker generator and packing the pacemaker pocket. Upon disconnecting the pacemaker the patient became profoundly bradycardic, and I immediately reconnected the pacemaker. Given his dependence on the pacemaker and lack of overt infection I elected to irrigate the pacemaker pocket with warm Clorpactin and placed the pacemaker in an antimicrobial absorbable patch."