Ask Dr. Z

Dr Z, Could you review the below procedure and advise how you would code? The patient had a pacemaker inserted two months ago and was complaining of pain at the generator site. The pocket was opened and the generator removed. Thresholds were tested and noted to be within normal range. The pocket was flushed and the generator was then reinserted but with pacemaker wires repositioned on top of the generator instead of the bottom. If I understand correctly, this would not be a lead repositioning since the leads were moved in the pocket and not at the heart so was leaning toward unlisted 33999. However, in reading the Q&A from November 22, 2011, should this be considered a pocket revision although only the leads were "revised" within the pocket? Please explain. Thanks.