Wiki Help with Pacemaker replacement

[nikmpayne]

I could use some help with this:

The patient had a replacement of dual chamber pacemaker due to end of battery life.

I bellieve the coding should be:

33213
33202
33222
C1785

Am I correct that 33233 would be included in 33213, or are we able to also code for the removal of the old pacemaker?

Also, since the dr is "fixing" the scar from the previous pacemaker, can we also bill 12032? (wth a modifier and notes?)

Here is the op note:

A elliptical incision of the prior pacemaker scar was then performed to remove the old hypertrophed scar. Skin and subcu tissues were then dissected down to the scar. this released the old scar tissue from the underlying tissue. The subc tissues were dissected downuntil the pect muscle. The pacemaker was noted to be underneath the pect miscle. A window was created thru the pect muscle which exposed the pm pocket. The pm was then delivered from the old pm pocket. determined that a new pm pocket was necessary.

Goes on to detail the atrial and vent leads positioned and checked.

Thanks for helping out this new to pacemaker coder.

 

[nikmpayne]

After doing quite a bit of reading, I now believe that the codes should be:

33213
33222
33233
12032

I am stuck on the scar, should 11406 be also coded for excising it?

Am I on the right path?

Thanks