# TAVR Help needed



## kbritt77 (Dec 3, 2012)

Our doctor performs an open aortoiliac closure with creation of a conduit for delivery of endovascular aortic valve prosthesis via retroperitoneal incision. The only code I can find to use is 34833. I'm skeptical about using that code because it states "delivery of aortic or iliac endovascular prosthesis" this is actually a cardiac endovascular prosthesis. Should I use an unlisted code??? thoughts please. 
__________________
Kathy


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## jewlz0879 (Dec 3, 2012)

You'll want to use 0257T. For TAVR in 2011 they do not have assigned CPT codes, only Category III, however, in 2013 they will have their own code. 

0256T - Endovascular/Percutaneous approach for TAVR delivery

0257T - Open thoracic approach; 0258T without CP bypass; 0259T with CP bypass. 

HTH


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## jeanne4 (Dec 3, 2012)

*Tavr*

Medicare has policy on this - CR 7897 for CPT 0256T will get new code in 2013


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## kbritt77 (Dec 3, 2012)

Thank you but we are not billing out the primary code. We are billing the conduit so that the cardiologist can use his device.


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## jewlz0879 (Dec 3, 2012)

Ah, gotcha. Hmmm, I've never encountered this before. I like 34833 and didn't the Cardio doc deliver the device endovascularly? See below. Maybe this will help. If not, talk to the physician and see if he is okay with unlisted IF 34833 or some other code doesn't really capture what he/she did. 

34820 includes delivery of the prosthesis; not just the exposure and conduit as in 34833. 

34833
Staff preps the patient and anesthesia is administered. The surgeon makes an incision in the abdomen/retroperitoneum to access the iliac artery, moviing soft tissue, organs and vessels, as needed. She opens the iliac artery sufficiently to connect a conduit to the iliac. After separately reportable endovascular repair is completed via the conduit, the surgeon either attaches the open end of the conduit to the other iliac to act as a bypass graft or he/she detaches the conduit and closes the artery.


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## kbritt77 (Dec 3, 2012)

*Tavr*

the only issue I have is that it states endovascular Aortic or iliac device. This is an endovascular cardiac device


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## jewlz0879 (Dec 3, 2012)

Yes but a TAVR is an Transfemoral/Apical Aortic valve replacement. Do you have access to a site that can help you answer this? Say Supercoder.com or MedLearn? 

http://www.panaceahealthsolutions.com/question-of-the-week.html Go here and see if you can find it in the archives. You can sign up for the compliance question of the week. You can submit a question. 

HTH


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## kbritt77 (Dec 3, 2012)

*tavr*

thanks


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