# Removal of Pacemaker Wire



## vdhariwal (Feb 5, 2015)

I am having a lot of trouble to find a correct code for Removal of pacing wire- i came up with 33233-(Removal of permanent pacemaker pulse generator only) but not 100% sure.

Indication- Pt underwent a complex mitral valve repair and had atrial and ventricular pacing wires. The ventricular pacing wire was removed completely,but the atrial wire,which was clipped on to the atrium, was only snipped at the skin level. The patient had an MRI and developed a severe burning feeling at the site of the pacing wire. He is being to the operating room. 

Operative Report- We did an intraoperative TEE to be sure that there was no injury.Based on the CT scan, a small incision was made over the xiphoid and the pacing wire was explanted out. When we were pulling, we could feel the heart beating indicating that it must be very,very struck to the atrium.We pulled up gently and snipped it as low as we could.I feel uncomfortable and it would be too dangerous to put it out completely as it would definitely tear the atrium. 

I would totally appreciate your time and feedback.


----------



## Jim Pawloski (Feb 5, 2015)

vdhariwal said:


> I am having a lot of trouble to find a correct code for Removal of pacing wire- i came up with 33233-(Removal of permanent pacemaker pulse generator only) but not 100% sure.
> 
> Indication- Pt underwent a complex mitral valve repair and had atrial and ventricular pacing wires. The ventricular pacing wire was removed completely,but the atrial wire,which was clipped on to the atrium, was only snipped at the skin level. The patient had an MRI and developed a severe burning feeling at the site of the pacing wire. He is being to the operating room.
> 
> ...



Try 33236 - removal of electrode by thoracotomy.
Thanks,
Jim Pawloski, CIRCC


----------

