# Pocket revision...



## jwhite2637 (Feb 5, 2014)

For visits where all that is done is a revision of a pacemaker or AICD pocket, how do we code that?  It was our understanding that the revision is no longer billable and that we could only bill if they relocated the pocket.  

thoughts?


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## Margaret Morgan (Feb 17, 2014)

Per Dr. Z's cardiology coding "reference report 33223 for relocating the pocket for infection, unplanned migration of generator, moving to a submusclar location of "twiddlers", and erosion or potential erosion of skin by the generator."

You do not use the 33223 for revision of the pocket during generator/battery changes.  revision is included in generator change UNLESS you move the pocket.

Margaret CPC


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## jwhite2637 (Feb 17, 2014)

Margaret Morgan said:


> Per Dr. Z's cardiology coding "reference report 33223 for relocating the pocket for infection, unplanned migration of generator, moving to a submusclar location of "twiddlers", and erosion or potential erosion of skin by the generator."
> 
> You do not use the 33223 for revision of the pocket during generator/battery changes.  revision is included in generator change UNLESS you move the pocket.
> 
> Margaret CPC



Margaret, thanks for your response!  Perhaps you can help me further.  here's the doc's procedure description:

_PROCEDURE:  The patient presents for implantable cardioverter-defibrillator pocket revision with pre and post procedure implantable cardio-defibrillator system evaluation and programming.  _

That's basically all he did.  He took the generator out, enlarged the pocket, and put the same generator back in.  I'm really stumped on how to actually code this.  thoughts?


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## jwhite2637 (Feb 21, 2014)

thoughts?


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## meganbruce (Aug 14, 2014)

jwhite2637 said:


> thoughts?



Ended up with one of these on my desk today... has anyone on here helped out with this question?

My sx rpt is well after the global 90 days...and dx is 996.72, pt is having severe pain at site of pacer implant. 

Any help would be greatly appreciated


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