# PDA Closure



## lenamarie73 (Oct 1, 2008)

Hi All,
Just wanted to know if anyone knows how to code a PDA closure with Amplatzer Duct Occluder?  

Thanks  

Lena


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## MLS2 (Oct 1, 2008)

here's one idea...


33822/33824]:  The physician gains access to the mediastinum through an incision through the posterolateral left chest wall (posterolateral thoracotomy). The physician dissects through the posterior chest wall musculature to expose the superior mediastinum. The physician dissects away the tissues surrounding the ductus and passes several heavy ligatures around the ductus and ties it off (ligation) at each end. The physician occludes the ductus with vascular clamps and divides the ductus with scissors. The physician closes the aortic end with suture, then closes the pulmonary stump. The physician removes the vascular clamps, sutures the pleura closed, closes the remaining surgical incisions and dresses the chest wall wound. The physician may leave chest tubes and/or a mediastinal drainage tube in place following the procedure. Report 33824 if the patient is 18 years and older.


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## lenamarie73 (Oct 1, 2008)

This is all done through percutaneous entry in the Cath Lab. I found this site that actually shows how it's done. Now I just need to find out how to code it?? 

http://www.amplatzer.com/USProducts/PDADevice/tabid/193/Default.aspx


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## MLS2 (Oct 1, 2008)

i'll keep looking then...I wasn't sure which method was used.
thanks!


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## lenamarie73 (Oct 1, 2008)

Thanks so much!


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## Davistm (Oct 16, 2008)

Lena,

I looked at a couple of web sites including Amplatzers and you are probably looking at an unlisted code.  Codes 93580, 93581, 37204 or 36013 are not appropriate, but may provide a basis for estimating RVUs.

It appears that the Amplatzer device has FDA approval [I assume the procedure does also].  However, this does not imply that any insurer provides coverage for the procedure or the device. [Are you participating in any type of post approval studies or trials for this devise?]

This site has some general information on transcatheter repairs of ASD, VSD and PDA: http://circ.ahajournals.org/cgi/content/full/97/6/609.
It may also provide leads to additional information.

This Amplatzer site has specific information on the devise/procedure:
http://www.amplatzer.com/USProducts/PDADevice/tabid/193/Default.aspx.

On the right side, notice a link for reimbursement advise.  I would contact Amplatzer and see what they recommend for coding and billing. With that information, I would contact prospective payers and work with them on the reimbursement issues.  While you're on the Amplatzer site, I would find and download a good written description of the procedure and devise.

Good luck.

Terry Davis
CPC


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