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PPM gen removal and replace- add new deep septal /left bundle lead

Date: Aug 31, 2022

Question:

Patient had RA RV leads. Physician placed a deep septal/LV lead.

"Using the glidewire, a steerable His sheath and dilator were advanced past the tricuspid valve and extended towards the septum just distal to the tricuspid valve. A passive fixation 3830 His lead was advanced and using pacing morphology guidance, a suitable deep septal site was identified. The lead was advanced using passive fixation but failed to achieve appropriate pacing morphology (rsR in lead v1) and the lead was withdrawn and repositioned further proximally towards the septal tricuspid valve. A second appropriate site was identified using pacing morphology. The lead was advanced and appropriate narrowing with acceptable pacing morphology was identified. Adequate pace/sense parameters were obtained. We now have RA, RV and a Deep septal / LB lead WITH NEW GENERATOR. Analysis and programming of a biventricular PPM at implant."

How would this be coded? Is it 33229 and 33225? Or 33229 and 33216? He's calling it a biventricular placement.

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