Wiki Cardiac electrophysiology procedure

allowry5

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Laotto, IN
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After informed consent the patient was brought to the EP lab. He was
placed in the supine position. An appropriate time-out was called. He was
reassessed prior to sedation.

The right infraclavicular area was prepped and draped in a sterile
fashion. Anesthesia was obtained with 1% lidocaine injected locally as
well as conscious sedation administered throughout the procedure. A
diagonal incision was made over the existing pulse generator. The pocket
was opened using cautery and sharp dissection. The existing generator was
removed from the pocket.

The right subclavian vein (transvenous) was cannulated on 3 occasions. There was
difficulty navigating the subclavian vein. 10 cc of contrast instilled
through the stick site did demonstrate 2 areas of stenosis 1 lateral and 1
medial. The areas of stenosis were navigated successfully.

A Saint Jude lead was placed in the RV apex. The helix was extended into
the ventricular myocardial. Firm tissue contact was confirmed by general
back traction. Appropriate pacing and sensing function were documented.
The lead was sutured in place using the supplied tie-down and 2 0 silk
sutures.

The lead was then connected to the existing generator. The previous RV
lead was capped. The pocket was copiously area with ABx containing
solution. The device was placed in the pocket with the capped lead behind
it. The pocket was closed in 3 layers. The 1st layer consisted of
running 2 0 Vicryl. The 2nd layer running 3 0 Vicryl. The final layer


Patient's lead was replaced and attached to existing generator. What CPT code would be used for just the replacement of the lead?
 
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