Wiki Aortic Root Reconstruction with Aortic Valve replacement

[AlaskanCoder]

I am trying to find a code for a reconstruction of the Aortic Root after replacement of a failing bioprosthetic aortic valve. He wrote, in part, "The aortic valve was exposed via a hockey=stick type of incision. Initial findings were as described. It was impossible to access the prostehtic valve given the narrowing of the sinotubular junction by the rigid calcium shelf formed by teh existing bovine pericaridal patch. The ostium of the right coronary artery was identified and protected and then the aoric root between the right coronary artery and the midportion of the noncoronary cusp was completely excised. This opened up the access to the bioprosthesis, which was explaned. Annular fibrotic tissue and pledgeted matrial were completely debrided. A 23 mm St. Jude Regent was placed in a supra-annular position with interrupted 2-0 Ethibond stitches, reinforced with Teflon felt pledgets placed on the ventricular side of the annulus. The aortic root was reconstructed with a new, large piece of bovine pericardium, significantly enlarging the area of the sinotubular junction."
I cannot find a code for the reconstruction. It seems to me like this more than described in 33412 and definately not what is described 33864 since there was no "valve sparing".
Can anyone suggest how this should be coded?

Thank you in advance,
Karen

 

[sandy06]

I think you should take a look at Cpt Code 33863, and for the Reconstruction it will be included into the procedure.

A 23 mm St. Jude Regent was placed in a supra-annular position with interrupted 2-0 Ethibond stitches, reinforced with Teflon felt pledgets placed on the ventricular side of the annulus.

It is a valve he is using; you can lick on the web page below and take a look at the difference types of valve. Hope it helps..




http://www.sjm.com/corporate/media-...rapies/valvular-disease-and-heart-valves.aspx