CPT® Code 0518T

1. Indications

The removal of the pulse generator for a wireless cardiac stimulator is indicated in specific clinical scenarios, including:

• Infection of the existing battery pocket - This may necessitate the removal of the pulse generator to prevent further complications and ensure patient safety.
• Complications related to the implanted device - Such complications may include issues with the device's functionality or adverse reactions that require intervention.

2. Procedure

The procedure for the removal of the pulse generator involves several critical steps to ensure a safe and effective extraction:

• Step 1: Incision - An incision is made over the previous implant scar site, which is typically located to the left of the transmitter pocket. This approach helps to minimize additional trauma to the surrounding tissue.
• Step 2: Accessing the Battery Pocket - The subcutaneous pocket where the battery is housed is accessed through the incision. Care is taken to avoid damaging surrounding structures during this process.
• Step 3: Removal of the Battery - The battery component of the pulse generator is carefully removed from the pocket. This step requires precision to ensure that the integrity of the surrounding tissue is maintained.
• Step 4: Disconnecting the Transmitter Cable - A torque wrench is utilized to disconnect the transmitter cable from the battery. This step is crucial to ensure that the cable is removed without causing damage to the remaining components.
• Step 5: Capping the Connector Pin - After the transmitter cable is disconnected, a cap is placed over the connector pin of the remaining transmitter cable. This helps to protect the connector and prevent any potential complications.
• Step 6: Closing the Wound - Finally, the incision is closed with sutures, ensuring that the site is properly sealed to promote healing and reduce the risk of infection.

3. Post-Procedure

Post-procedure care involves monitoring the incision site for signs of infection or complications. Patients may be advised on wound care and signs to watch for that could indicate issues such as increased redness, swelling, or discharge. Follow-up appointments may be scheduled to assess healing and determine if further intervention is necessary. It is essential to provide patients with clear instructions regarding activity restrictions and any medications that may be prescribed to aid in recovery.