I found this out on the web:
When the procedure is a revision (as this one is), the physician is draining a hematoma, debriding scar tissue or an infection and/or enlarging the existing pocket for the pacemaker. In any case, the end result is that the physician is placing the generator back into the original pocket. The CPT manual directs you to select one of the following integumentary codes for the procedure, as appropriate: Incision and drainage (10140 and 10180) or debridement (11042, 11043, 11044, 11045, 11046 and 11047).
Note that a relocation, by contrast, involves opening the existing pocket, incising and draining any abscess or hematoma that is present, closing that pocket and creating a new pocket where the generator is then placed. The CPT manual directs you to report code 33222 for relocation of a pacemaker or 33223 for relocation of a defibrillator.
Check your payer’s policy for reporting wound closure with a debridement. Medicare, for example, doesn’t allow it for procedures with a global surgery indicator of 000, 010, 090 or MMM, except for certain cases such as Moh’s surgery or excision of malignant lesions and benign lesions greater than 0.5 cm. Code 11042 has a 000 global period, so wound closure would not be separately billable, based on these rules. (Medicare National Correct Coding Policy Manual, Chapter 3).
If separate payment is permitted, the four-layer closure documented would likely fall under an intermediate closure. The surgeon does not document the size of the wound repaired, so you’d report code 12031 (Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities [except hands and feet]; 2.5 cm or less).
So it looks like you should look in the Integumentary System codes. Hope it helps!