Ask Dr. Z

"The capsule was incised and the generator removed from the pocket.  The leads were visually inspected and found to be free of any  obvious defects. The pace/sense characteristics of the leads  were found to be functioning normally. The generator pocket was  relocated with extension deeper towards the pectoralis fascia and  more superiorly due to the superficial nature of the original  generator pocket and risk for skin erosion. The pocket was  flushed with Gentamicin irrigation solution. The generator was  connected to the leads and implanted in the pocket. The  connections were tested and found to be functioning  satisfactorily. The pocket was closed in layers using 2-0, 3-0, and 4-0 absorbable suture." I would only code for this replacement of pulse generator. Should pacemaker pocket relocation be also coded since deeper toward the pectoralis fascia and there was a risk of skin erosion? Or there needs to be active erosion and deeper toward subpectoralis instead of pectoralis in order to code relocation?