bennieyoung
Guru
I am being audited and my auditor doesn't agree with the cpt code I picked for this procedure. Could someone look at it and tell me what they would use? Thanks in advance for any help!
ICD Dual Chamber Generator Change
Indications
ICD (implantable cardioverter-defibrillator) battery depletion [Z45.02 (ICD-10-CM)]
Pre Procedure Diagnosis
ICD (implantable cardioverter-defibrillator) battery depletion [Z45.02]
Conclusion
Procedure:
Generator Change out: ICD
Indication: Device at ERI
Sedation: Please see anesthesia record
Antibiotics: Ancef and vancomycin IV
The patient was prepped in the usual way for CRM generator change out
Time-out performed
The existing incision was cut using the blade and electrocautery.
Using electrocautery and blunt dissection in the subcutaneous fascia the device pocket was entered. The capsule was entered.
The generator was removed from the pocket. The existing cables were detached from the header and attached to the new pulse generator header.
The pocket was flushed copiously with antibiotic solution.
The pulse generator was placed inside the pocket with the cables coiled underneath it. A tyrx pouch was used.
The pocket was then closed in the usual fashion using 2-0 Vicryl, 3-0 and 4-0 Vicryl.
Steri-Strips were applied over the incision.
A light dressing was placed over the incision. The patient was transferred to a monitored bed in stable condition.
Company Model Serial number
Pulse generator Medtronic
Atrial lead Medtronic
Right ventricular lead Medtronic
LV Lead Medtronic
Explanted Pulse Generatpr Medtronic
Right ventricle Left Ventricle Right atrium
Threshold 0.75 volts at 0.4 milliseconds (1-2)
1 at 0.4 -
Sensing 11.6mV 2.5 mV
Impedance 418 Ohms 589 456 Ohms
VF 200, ATP during charge, max shocks
Monitor 182
VVIR 70-120
Conclusion:
Successful BIVICD generator change out
D/C today
Oral Abx x 7 days
F/u in device clinic as scheduled
ICD Dual Chamber Generator Change
Indications
ICD (implantable cardioverter-defibrillator) battery depletion [Z45.02 (ICD-10-CM)]
Pre Procedure Diagnosis
ICD (implantable cardioverter-defibrillator) battery depletion [Z45.02]
Conclusion
Procedure:
Generator Change out: ICD
Indication: Device at ERI
Sedation: Please see anesthesia record
Antibiotics: Ancef and vancomycin IV
The patient was prepped in the usual way for CRM generator change out
Time-out performed
The existing incision was cut using the blade and electrocautery.
Using electrocautery and blunt dissection in the subcutaneous fascia the device pocket was entered. The capsule was entered.
The generator was removed from the pocket. The existing cables were detached from the header and attached to the new pulse generator header.
The pocket was flushed copiously with antibiotic solution.
The pulse generator was placed inside the pocket with the cables coiled underneath it. A tyrx pouch was used.
The pocket was then closed in the usual fashion using 2-0 Vicryl, 3-0 and 4-0 Vicryl.
Steri-Strips were applied over the incision.
A light dressing was placed over the incision. The patient was transferred to a monitored bed in stable condition.
Company Model Serial number
Pulse generator Medtronic
Atrial lead Medtronic
Right ventricular lead Medtronic
LV Lead Medtronic
Explanted Pulse Generatpr Medtronic
Right ventricle Left Ventricle Right atrium
Threshold 0.75 volts at 0.4 milliseconds (1-2)
1 at 0.4 -
Sensing 11.6mV 2.5 mV
Impedance 418 Ohms 589 456 Ohms
VF 200, ATP during charge, max shocks
Monitor 182
VVIR 70-120
Conclusion:
Successful BIVICD generator change out
D/C today
Oral Abx x 7 days
F/u in device clinic as scheduled
