# How would you code ligation of atrial appendage?



## ktsirtsan (Dec 2, 2009)

Patient had 2 CABGs done and while the heart was retracted, sutures were placed around the base of atrial  appendage and tied. A heavy silk tie was used in addition to this.

KT


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## Michelle Thompson (Dec 3, 2009)

That's a good question.  I usually see this when a MAZE procedure 33254 is done and I was told the oversewing is included in the MAZE procedure.  There is no billable code when done without maze. 
See the notes on page 148 of the CPT 2009 Professional Edition - under the Electrophysiologic Operative Procedures.
Please post if you find further information.


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## lisigirl (Dec 3, 2009)

There isn't a code for this. Per the Society of Thoracic Surgeons, LAA ligation is included in all Maze and mitral valve procedures. If done with a CABG or other cardiac procedure, you could consider adding a modifier -22 if medical necessity is met.

The STS may look into having a code created for this down the road.

Lisi, CPC


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## ktsirtsan (Jan 11, 2010)

Thank you for your help!


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