Ask Dr. Z

Please do NOT include any actual patient medical records with your question. Have cardiologist that wants to charge 33216(lead replacement,33233(PM removal), 33234(lead removal) and 33222(pocket revision) on patient that required replacement of chronic RA lead due none capture. Per patient's report generator removed, leads tested (noise defect reproduced with pressure on part of lead entering cephalic vein), Chronic RA lead removed, new lead placed, connected to generator, pocket washed with gentamycin saline and pocket closed. Per report no new generator placed and no revision of pocket. My understanding is that 33216 bundles the chronic PM removal and replacement. And documentation not adequate for charge of revision of pocket.Do you have avialable clear instructions on what is included in lead repair/replacement procedures. Thank you for your help. Rick