Ask Dr. Z

Incision extended to pre-existing pocket. Device was freed from the pocket. There is pus coming from the pocket which was irrigated & culture sent. Leads disconnected from old generator. All 3 leads were able to be easily removed with placement of stylette and retraction of the screws with gentle traction. The upper pocket incision was then. Access obtained to left IJ under ultrasound guidance with placement of guidewire. A 6 French peel-away sheath was then advanced over which a Boston Scientific pacing lead was advanced to the right ventricular apex and secured with active fixation. The explanted generator was then cleaned and attached to the lead and the atrial port. The RV and LV port were then plugged with pin plugs. Externalized device and lead used to continue backup pacing for a few days.

I am new to EP I currently have 33244, 33241. Would I also add 33234 since there were 3 leads removed, or since there was a new lead attached for the external device leave the 33234 off of the claim?