How to code - dual chamber pacemaker pocket revision?

KScoderTN

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A member needs help coding this op note. Those who specialize in cardiology, would you please take a look and offer guidance? Coder was looking at 33222 but the pacemaker was not relocated, it was reinserted in same pocket and secured. How would you code?

Thank you in advance.





Preoperative Diagnosis: Pacemaker pocket bleeding

Postoperative Diagnosis: Pacemaker pocket revision



Procedure Performed: Dual Chamber Pacemaker pocket revision

Anesthesia Type: Mac

Complications: None

Description of Procedure

See cardiac catheterization laboratory report for technical details. The left shoulder was prepped and draped in the usual fashion. Under local anesthetic and IV sedation, an incision was made below the left clavicle over the old device. The device was removed from the pocket and the leads were removed from the device and tested. Visual inspection showed that the leads were in good condition. The RV lead yielded excellent pacing and sensing values. The RA lead was tested and yielded excellent pacing and sensing values. Culture swabs were sent for analysis. There was no signs of active infection or pus. The pocket was checked for hemostasis and then copiously irrigated with antibiotic solution. The pocket was closed in 3 layers with absorbable suture. Steri-strips were placed across the incision and a sterile dressing was applied. The patient tolerated the procedure well and no complications were observed.
 
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