by Lynn Kuehn, MS, RHIA, CCS-P, FAHIMA
Making or enlarging a defect in the atrial septum is a vitally necessary, emergent procedure for neonates with Transposition of Great Vessels or Hypoplastic Left Heart Syndrome. Making the defect creates an artificial bypass between the left and right atria of the heart and allows unrestricted blood flow that helps meet the immediate oxygen needs of the neonate.
The procedure of enlarging the opening or creating an opening where none exists to reroute the blood is the root operation of Bypass (Altering the route of passage of the contents of a tubular body part). This is a catheter-based, balloon procedure where the balloon is deployed into the left atrium. While deployed, the catheter and balloon are forced back through the atrial septum into the right atrium, creating or enlarging a hole that allows the mixing of the blood between the atria. The procedure is done in the Cath Lab, or, if necessary, at the bedside in the neonatal ICU.
The septum needs to be opened to make this bypass, rather than being repaired or excised. The percutaneous approach is available for the body part value of right atrium and a qualifier of left atrium to describe the mixing of the blood supply, allowing a code that describes the procedure correctly. For a short, animated video of the procedure from the Children’s Hospital of Philadelphia, click here.
To learn more about coding corrective procedures on congenital heart anomalies, click here.
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