Preop Dx: Implanted permanent pacemaker with pacemaker siteerosion Postop Dx: Same Procedure: Relocation of pacemaker sitewith re-implantation of the pulse generator into the pectoralismuscle Anesthesia: Local Procedure Description: The patient wasbrought to the Cardiac Catheterization Lab in the fasting state.She was prepped and draped for a left infraclavicular approach.Lidocaine anesthesia was administered. A skin incision wasperformed. Using meticulous dissection, muliple indwelling leadswere dissected away and the pulse generator was extracted. This wasan Intermedic Nova, model 282-04, serial #355543, bipolarventricular pacer. Deep dissection was performed and the pulsegenerator was placed in a new pocket in the pectoralis muscle belowthe current pocket. The lead and pacemaker were carefully sutureddown. Interrupted 3-0 Dexon was utilized to close the area in orderto achieve maximum tissue coverage of the multiple leads. Therewere no complications. The patient left the lab in good condition.Were the pacemaker leads replaced during this procedure? What is a“pulse generator”? Was the pulse generator replaced? What CPTsurgical section code(s) would you assign? How did you index thiscode in CPT index (what terms did you use)?
