Ask Dr. Z

Hi, I have a Pacemaker at ERI with pocket revision and lead repair noticed during the PM Gen replacement. However CCI is saying that codes 33228 and 33218 can not be coded together even with a modifier because it is a component of column one. So I don't know how to code this lead repair with the new codes, please help. Below is part of the dictated report: Pre op: Pt pacemaker at ERI. In addition skin has been thinned over the pm superior aspect of the incision line. "The ventricular and atrial leads worked well. There was a crimp in the ventricular lead, although there was no alteration of functon and no palpation of any wire. The insulation was repaired in that location with medical adhesive and a silicon sleeve. It was tested again and worked well." Post op: Successful removal and insertion of dual PM. Repair with silicon sleeve and medical adhesive of crime in the venricular lead. Successful revision of the PM pocket to allow the PM to sit more deeply in the pocket and take pressure off the superior incision line.