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Cardio seal patch repair of right atrium

Sonnia Posted Wed 01st of June, 2016 16:03:40 PM
A cardioseal patch repair of the right atrium was performed with a 33405 and 33641. Is this considered inclusive? I can't find a code. See note below. The right atrium was opened and the PFO was closed primarily with running Prolene suture.  The right atrium was quite friable and the atriotomy would have been under a bit of tension had it been closed and also will compromise the size of the atrium since this was a small atrium.  As such, we decided to perform a patch closure.  A CardioSEAL patch was then used to reconstruct the right atrial wall. 
SuperCoder Answered Thu 02nd of June, 2016 03:25:25 AM
Thanks for the question. The provided documentation shows that the physician has performed closure of the atrial PFO with the patch. So the CPT code suggested by you (i.e. 33641) is correct to report but another code (i.e. 33405) is for replacement of aortic valve and if your physician has performed replacement of aortic valve too, then definitely you can report both CPT codes (i.e. 33405 and 33641) since there is no CCI edit between these two codes. Thanks.
Sonnia Posted Thu 02nd of June, 2016 11:21:44 AM
Ok, how about the cardioseal patch that was used to recontruct the right atrial wall. Is that included in the aortic valve replacement or is there another code?
SuperCoder Answered Mon 06th of June, 2016 02:29:04 AM
Hi, please note that the atrial wall repair cannot be reported because of these reasons: 1). Right atrium is opened to allow access to the atrial septum to repair atrial septal defect PFO. So this is the part of the procedure. 2).There is no diagnosis of the atrial wall. Thanks.

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