Ask Dr. Z

How would you bill an epicardial pacemaker system insertion with open insertion of LV and RV leads?

"The bipolar epicardial steroid-eluting leads were then placed on the lateral wall of the LV, and each lead was secured with 4-0 prolene suture... As the heart was reperfusing, an RV epicardial steroid-eluting lead was then placed on the diaphragmatic surface of the RV and on the anterior surface of the RV and secured with 4-0 prolene. Both leads were brought out through the intercostal space. A left subclavian pocket was fashioned, to which the leads were brought and eventually hooked to the bipolar pacemaker."