Ask Dr. Z

I would appreciate some help with this AICD scenario. The patients come in for a replacement atrial or ventricular lead due to malfunction of the lead (not a recall). The physician replaces the lead and also the generator. It is not dictated that the generator is at end-of-life. I believe the replacement is so that the patient does not have to have another surgery anytime soon when the generator is actually at end-of-life. I used CPT code 33249. Can codes 996.04 and V53.32 be used for secondary prevention in this scenario, even though the generator may not be at end-of-life? Or, can the lead issue be ignored and the -Q0 modifier used? These patients were originally primary prevention.