REVISION Reveal Monitor 33282 and 33284


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underwent a Reveal implantation, which initially had good sensing, however, his sensing became worse, likely secondary to some minor movement or possibly scarring. He had an episode of syncope, however, because of the under sensing of his device, it did not detect this episode. He is being brought in to remove and replace his Reveal monitor to insure that we capture his next episode of syncope.

After informed consent was obtained, the patient was brought to the operating room in a fasting state. The left chest was prepped and draped in the usual fashion. Lidocaine was used to anesthetize the area over the prior incision. Incision was made, and the tissue was resected down to the previous Reveal device. The sutures were cut, and this device was removed from the pocket. The pocket that had previously existed for this device was then closed with 2-0 silk.

Using a Metzenbaum for blunt dissection, a new pocket was made, which was laterally directed and had a vector that proved to be superior from a sensing standpoint. The device was inserted into the pocket, and it was sutured down to the pectoralis muscle at two different locations around the header.

I am asking if I can use 33282 and 33284 with mod. 59 due to the fact it is two seperate pockets and new implant.....Anyone have opinions? OR IS IT UNLISTED 33999? BECAUSE I CAN'T FIND A REVISION CODE.
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