Ask Dr. Z

Would it be appropriate to bill for a pocket relocation in this scenario?

"Initially a 4 cm incision along the left deltopectoral over the prior incision was made along with electrocautery and blunt dissection, but it was noted that the device had migrated significantly inferiorly and laterally. The device was unable to be reached via this incision. This incision was sewn in three layers. Next fluoroscopy was used to locate the device more accurately. A second incision was made inferior to the first, and using blunt and electrocautery dissection the pacemaker was removed from the pocket floor. The leads were removed from pacemaker generator inserted into the new generator."