Ask Dr. Z

My provider states that he opened the pacemaker and the generator and leads were just subdermal with threatened erosion. The pacemaker leads and pocket had extensive calcification and the leads were coiled on top of the generator. With extreme difficulty the generator was removed from the pocket and leads dissected away from scar tissue. The leads were dissected away from the fat and the pocket was then made down to the prepectoral fascia. The leads were then followed to the muscle and secured. Leads tested functioning normal. Scar tissue was removed from pocket. New generated inserted. He is wanting to bill a 33215, 33222, and 33228. I know that he cannot bill 33215 for moving leads around within the pocket. Also, basically the pocket was made deeper and not moved. Would just billing the generator change 33228 be correct with perhaps a -22 modifier for the extra work for the pocket revision?