bhargavi
Guru
Patient presented with discomfort and protuberance of some of the leads with a relatively superficial pocket.
After sterile preparation and wide infiltration with local anesthesia, an incision over the generator was created. It was noted that the leads were actually found to be superficial to the pulse generator. Dissection was carefully done using PlasmaBlade. The leads were freed up from the lead anchors to the generator. The pocket was then expanded and moved inferiorly and also somewhat deeper.
New pocket was irrigated with antibiotic solution. The pacemaker and leads were placed into a Tyrx antibiotic envelope. Note that the leads are now beneath/deep to the pulse generator. A single stitch was placed so that the Tyrx pouch would not move or rotate.
The overlying skin was closed using 3 layer technique with suture.
should i do 33215 or unlisted 33999?
thanks in advance
After sterile preparation and wide infiltration with local anesthesia, an incision over the generator was created. It was noted that the leads were actually found to be superficial to the pulse generator. Dissection was carefully done using PlasmaBlade. The leads were freed up from the lead anchors to the generator. The pocket was then expanded and moved inferiorly and also somewhat deeper.
New pocket was irrigated with antibiotic solution. The pacemaker and leads were placed into a Tyrx antibiotic envelope. Note that the leads are now beneath/deep to the pulse generator. A single stitch was placed so that the Tyrx pouch would not move or rotate.
The overlying skin was closed using 3 layer technique with suture.
should i do 33215 or unlisted 33999?
thanks in advance