Removal and replacement of existing right ventricle lead for ICD

May 30, 2017

Question:

"Relocated pocket and ICD from the right to left side of the chest using the same generator and same RV lead. After this, I proceeded to the right side where I reopened the previous incision going through the same scar. The device was delivered out of the pocket. The pulse generator was disconnected and washed with antibiotics. The old lead was freed of any of the stitches around it, and, under fluoroscopic guidance, I unscrewed it and then pulled the lead out. It came out in its entirety. The lead was visually intact. I irrigated it also and cleaned it completely with antibiotic solution. The same lead was now already introduced through the introducer sheath that is in the left subclavian vein. I navigated that lead under fluoroscopic guidance into the apex of the right ventricle cavity. I actively fixated it. Pacing and sensing functions were assessed and were adequate. I thus fixed that lead to the fascia of the first and second ribs with multiple stitches of 2-0 silk." Would the lead relocation be 33215, or removal 33244 and replacement 33216, and 33223?

Question ID: 9412
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