What CPT code would you use for Removal of AICD epicardial lead system with removal of wires and leaving behind the epicardical patches in place and open packing of the wound.
I'm not sure what the correct code would be in this case. Any suggestions?
The patient was taken to the operating room and placed supine on the op room table. A longitudinal epigastric incision was made. The leads were readily identified and a large amount of pus was drained from around the leads, This then tracked up into the pericardium and then distally down to the left quardant. The leads were entirely extracted through a separate transverse left lower quadrant incision, along with all of the wires and lead covers. On tracking them up towards the heart, the leads went up into the pericardium. The two pacing leads were densely adherent and were pulled down and then cut off as high as they could be. The epicardial patches were identified. They were densely adherent on the surface facing the heart and the pockets were irrigated, but because of the adherent scar tissue to the surface of the heart it was elected to not open the sternum for removal of these patches. These were irrgated and the two wounds were closed with Kerlix packing.
I'm not sure what the correct code would be in this case. Any suggestions?
The patient was taken to the operating room and placed supine on the op room table. A longitudinal epigastric incision was made. The leads were readily identified and a large amount of pus was drained from around the leads, This then tracked up into the pericardium and then distally down to the left quardant. The leads were entirely extracted through a separate transverse left lower quadrant incision, along with all of the wires and lead covers. On tracking them up towards the heart, the leads went up into the pericardium. The two pacing leads were densely adherent and were pulled down and then cut off as high as they could be. The epicardial patches were identified. They were densely adherent on the surface facing the heart and the pockets were irrigated, but because of the adherent scar tissue to the surface of the heart it was elected to not open the sternum for removal of these patches. These were irrgated and the two wounds were closed with Kerlix packing.
