# Laser extraction of AICD leads



## vikas.maheshwari (Nov 2, 2009)

Hi I did not find any code in the CPT book for laser extraction of ICD leads.

Just see the below procedure how the physician performed it.

OPERATION
1. Automatic implantable cardioverter defibrillator pulse generator removal.
2. Transvenous laser extraction of dual pacemaker lead system.
3. Transvenous laser extraction of right ventricular pacemaker defibrillator
lead.
COMPLICATIONS: None.
PROCEDURE: After obtaining informed consent, the patient was brought to the operating room in a fasted nonsedated state. The left prepectoral chest was sterilely prepped and draped, and infiltrated with 1% Xylocaine using total of 10 mL. There was a large defect there from the infection. A transverse incision was made superior to the defect. Blunt dissection carried out to the prepectoral AICD pocket and the AICD was explanted. The pocket was widely debrided. The right atrial and left ventricular pacemaker leads were then sequentially lasered out using a #14 laser. Right ventricular pacemaker defibrillator lead was then laser extracted using a #16 laser. At the conclusion of the procedure, the pocket was vigorously irrigated and closed in 2 layers. 

The fascial layer closed using running stitch of 3-0 Vicryl, subcuticular layer
closed using mattress stitch of 4-0 Vicryl. Sterile dressing was placed. All
sponge and needle counts were correct.

In my opinion;

33241 and 33244 are the codes for the above service any other opinion really appreciated


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