# ICD Removal from left side and new implant on the right side.



## CardioCoder79 (May 9, 2013)

Hello All. Please see the note below. How should I bill for this? I am stumped. Thanks! 


FINAL DIAGNOSES:
1.   Insertion of a single-chambered implantable cardioverter-defibrillator
(ICD) system on this admission, via the right subclavian artery approach.
2.   Removal of an old left-sided implantable cardioverter-defibrillator
(ICD) generator, cutting and capping of the old ICD lead in the left pectoral
region.
3.   Carcinoma of the lung.
4.   Nonischemic cardiomyopathy with chronic systolic congestive heart
failure.

DISCHARGE REGIMEN:  Please see the medication reconciliation sheet for
details.  Follow up appointment with the undersigned in 10-14 days, ICD
Clinic, office visit, chest x-ray, EKG.

COURSE IN THE HOSPITAL:  The patient was admitted in the hospital because of the need for radiation therapy to a newly
diagnosed left upper lobe lung cancer.  It was felt that the patient required
intensive radiation therapy this initial treatment, and that the presence of
a left-sided ICD generator would interfere with the ability to perform
affective therapy.  As such, the patient was scheduled for generator removal today.
The lead was cut and capped to minimize the amount of lead in the left chest
field.  The lead was moved as far medially as possible. A new single
chambered ICD generator and lead were then implanted via the right subclavian
approach with the generator in the right infraclavicular region.  The
patient's procedure was uncomplicated and was discharged home 05/09/2013,
the day following surgery to outpatient follow up.


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## CardioCoder79 (May 9, 2013)

I'm thinking 33241 and 33249 but need some guidance.  

Thanks.


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