Ask Dr. Z

Please let me know if I am coding this correctly. Upgrade duel chamber to biventricular pacer/generator with pinned LV port on generator (33229). Cardiologist was unable to advance LV lead so venogram was done and lt. subclavian vein is occluded around leads. So a new access into the rt subclavian vein with new pocket created on the right with attempt of LV(CS) lead but still unsuccessful LV lead placement. The right attempt pocket area is closed and the old left pocket reused. (33225-74). He also attempted to put in a new RV lead but due to Lt. subclavian Vein occlusion and tortuous vessels the RV lead was not exchanged (33215-74-XS). They plan on trying at a later date to place the LV lead.