Ask Dr. Z

Hello Dr. Z. Pacemaker and AICD insertion codes include a subcutaneous pocket creation. If the pocket is created under the pectoral muscle at the time of implant, is the pocket creation still included? I see your advice on relocation to a subpectoral plane but nothing on initial insertion to a subpectoral location. Our plastic surgery providers will work with our EP providers to create the subpectoral pocket. Should we code this with the device insertion only or should we code the device insertion along with an unlisted code for the subpectoral pocket? Thanks Dr. Z!