by David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC
Aortic Valve Replacement with Ascending Aortic Aneurysm Hemashield Graft
Question:
Please review our coding. A group of us have put our heads together and after research we came up with code 33863 for the following op note:
“Aortotomy was performed and aortic valve inspected. Aortic valve was noted to be a bicuspid valve which was removed. Extensive annular debridement & copious irrigation was performed. A #25 Carpentier Edwards Ispiris was sized and sutured into place. The aortotomy was closed. Aortoplasty with aneurysmorrhaphy was performed with 3-0 sutures. Deairing of the aortic root was performed and aortic crossclamp was released. Deairing was confirmed by Tee (93314-26). Good prosthetic valve function was noted. Aortic cannula was removved, hemostasis confirmed, Ascending aorta wrapped with Hemashield graft down to a 2.7 cm diameter using ethibond sutures as stay sutures and then running suture closure.”
Answer:
This is not 33863, which is a Bentall procedure. The Bentall is replacement of the aortic valve and ascending aorta with a valved conduit. It also requires re-implantation of the coronary arteries into the graft.
Report code 33405 for the aortic valve replacement. Cannot tell with this limited service, but appears ascending graft placed for aneurysm, which would be 33859.
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