dellasanta
Contributor
The code for pulm valvotomy using dilators to open it is 33470, but this code is for closed heart. The open heart code, 33474 uses cutting to open the valve. How should I code an open heart valvotomy using dilators (no cutting)? Should I use an unlisted code or would this still be 33470 because the open heart was due to another procedure performed at the same time. Here's a portion of the op note:
"Once the cardioplegia administration was complete, the IVC was snared, and a right atriotomy was performed. The internal anatomy was evaluated. There was a large secundum ASD, and a smaller atrial septal
fenestration inferiorly. We excised the septum primum to create 1 defect. We turned our attention to the pulmonary valve and serially dilated it with Hegar dilators. An 18 mm dilator easily fit through the anulus which is an appropriate size for this patient. We brought the pericardium to the field and using 5-0 Prolene in running fashion, we closed the ASD with the autologous pericardial patch."
"Once the cardioplegia administration was complete, the IVC was snared, and a right atriotomy was performed. The internal anatomy was evaluated. There was a large secundum ASD, and a smaller atrial septal
fenestration inferiorly. We excised the septum primum to create 1 defect. We turned our attention to the pulmonary valve and serially dilated it with Hegar dilators. An 18 mm dilator easily fit through the anulus which is an appropriate size for this patient. We brought the pericardium to the field and using 5-0 Prolene in running fashion, we closed the ASD with the autologous pericardial patch."