AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2024 Issue 1; Ask the Editor

Implantable Cardioverter Defibrillator Complications

A patient with a dual chamber implantable cardioverter defibrillator presented for a generator change due to an elective replacement indicator (ERI). It was noted that due to the patient’s thin stature, the device was very protuberant with protrusion of one of the pacing leads. Therefore, a pocket revision was performed, in addition to the generator change. During surgery, the existing submuscular pocket between the pectoralis and pectoralis minor was revised to accommodate the new device. The old generator was removed from the pocket. The leads were detached and tested prior to being connected to the new generator. Lastly, the new generator was placed within the revised pocket. Should the lead protrusion due to the patient’s thin stature be considered a complication of the lead, although the lead was not replaced? What are the appropriate diagnosis code assignments? ...

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