Ask Dr. Z

I have a patient who had a pacemaker pocket revision due to discomfort. No infection, relocation not done except for a slight move within the same pocket; I&D was not done. What code would be appropriate in this scenario?

"Blunt and Bovie dissection was carried out down to the level of the existing generator. The generator was removed from the pocket. Leads were dissected free of scar tissue. Dissection of the pocket was carried out in a superior medial direction extending over top of the transpectoral lead insertion position. The leads were coiled under the device in a more favorable anatomic location. The device was tacked to the prepectoral fascia as superior medially as could be obtained, just medial to the lead insertion positions. The pocket was irrigated with 180 cc of antibiotic irrigant solution on once again examined for bleeding. Both leads were pulled tested and remained fixed in place in the header. The wound was closed using a standard 3-layer closure technique."