Question

question 8
2 pts
preoperative diagnosis: heart block
postoperative diagnosis: heart block
anesthesia: local anesthesia
name of procedure: reimplantation of dual chamber pacemaker
description: the chest was prepped with betadine and draped in the usual sterile fashion. local anesthesia was obtained by infiltration of 1% xylocaine. a subfascial incision was made about 2.5 cm below the clavicle, and the old pulse generator was removed. using the seldinger technique, the subclavian vein was cannulated and through this, the old atrial lead was removed, and a new atrial lead (serial # 6662458) was placed in the right atrium and to the atrial septum. thresholds were obtained as follows: the p - wave was 1.4 millivolts, atrial threshold was 1.6 millivolts with a resultant current of 3.5 ma and resistance of 467 ohms.
using a second subclavian stick in the seldinger technique, the old ventricular lead was removed and a new ventricular lead (serial # 52236984) was inserted and placed into the right ventricular apex. the thresholds were obtained and were as follows: r - wave was 23.5 millivolts. the patient was pacing at 100% at 0.5 volts, with resultant current of 0.8 ma and resistance of 480 ohms. when we were satisfied with the thresholds, the leads were connected to the pacemaker generator (serial # 22561587), which was inserted into the previously created pocket.
the wound was thoroughly irrigated with antibiotic solution and hemostasis was obtained. the incision was closed in layered fashion with 2 - 0 dexon. a compressive dressing was applied, and the patient tolerated the procedure very well. he was taken to the recovery room in satisfactory condition. what cpt codes are reported?

Explanation:

Step1: Identify the key procedure

The main procedure is re - implantation of a dual - chamber pacemaker. This involves removal of old components and placement of new ones.

Step2: Consider CPT code selection

Code 33208 is for removal and replacement of the pacing electrode(s) and pulse generator (dual - chamber). Code 33208 - 51 is used when multiple procedures are performed and 33241 - 51 is related to the specific steps in the process of dealing with the leads and generator.

Answer:

33208, 33208 - 51, 33241 - 51