Wiki Remove and put back SAME pacer generator

hsims

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Okay... our pt was sceduled to have his bi-vent pacer removed and have a bivent ICD placed. When our dr opened the pocket it was found to have "fat necrosis" in the pocket. Cultures were taken and sent off. With the status of infection unknown it was decided to hold off on the new generator implant and being that the patient is pacer dependant the old pacer generator was put back in. There was no pocket revision, no hematoma drainage, just a swab sent off.
How can I bill (or can I bill) for the removal and reinsertion of the same generator? All resources I have come across mention placing a new generator...

To add... 2 weeks later the patient was brought back for laser lead extraction of the left ventricular lead, the right ventricular lead, and the right atrial lead; pocket revision and debridement, and placement of a temporary pacemaker for later implantation of a new biventricular ICD on the right side. Would this date of service be billed with a 58 modifier?

Thanks in advance for ANY help you can give!!
 
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