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AHA Coding Clinic® for HCPCS - 2010 Issue 1

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A patient with known ischemic cardiomyopathy was seen at our facility. He is status post coronary artery bypass (CABG) and a bi-ventricular implantable cardioverterdefibrillator. He was recently noted to have intermittently elevated impedance in his right ventricular (RV) lead. This has progressively elevated. He is now noted to have an impedance greater than 3,000 with an increase in thresholds and was scheduled for lead removal and a planned implantation of a new RV lead. According to the procedural process the bi-ventricular defibrillator was explanted (removed) from the pocket. The atrial and left ventricular (LV) leads were both left attached to the defibrillator. The right ventricular (RV) lead was removed from the defibrillator and the proximal distal coil leads were left attached to the defibrillator. A pacemaker analyzer system was attached to the RV pacing lead. Testing of the RV pacing lead showed the lead was functioning properly. The lead was reinserted into the ICD and the ICD was placed back into the pocket. All of the remaining leads were tested showing no abnormalities. The pocket was irrigated with antibiotic solution and closed in layers. The defibrillator was reprogrammed. What would be an appropriate CPT code for the procedure performed? ...

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