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coding of a cabrol procedure with a bentall

Lynn Posted Fri 11th of November, 2016 04:46:21 AM
I have codes for all but the aortic root enlargement, with aortomitral curtain and also #2, and #5 for the cabrol procedure please help. Thank you 1. Redo sternotomy and cardiopulmonary bypass.33530 2. Aortic root enlargement with patch reconstruction aortomitral curtain. 3. Mitral valve replacement with 27 millimeter St. Jude mechanical valve.33430 4. Aortic root replacement with 23 millimeter St. Jude composite valve graft/Bentall procedure.33863 5. Left coronary artery implantation through an interposition graft, 6 millimeter, Cabrol procedure. 6. Tricuspid valve repair with MC3 ring.33464  
SuperCoder Answered Mon 14th of November, 2016 08:39:48 AM

CPT code 33863, in this procedure physician places an ascending aortic graft. Cardiopulmonary bypass is required. After circulatory arrest or if a cross-clamp can be placed on the aorta before its first branch, the aneurysm is opened. The hole in the aneurysm is lengthened along the aorta until the end of the aneurysm is reached. The aorta is divided at this point. A double layer of felt strips is placed circumferentially around the inner and outer circumference of the normal aorta with the aortic wall sandwiched in between. A Dacron tube graft is sewn to this end of the aorta and its felt layers. This area is where the aortic valve is located. If the valve closes normally, the aortic root size is reduced using stitches that also sew a double layer of felt to the aorta as previously described. This can only be done if the coronary arteries (which arise in this area) are not involved in the aneurysm. If the valve does not close normally, it is replaced or repaired with stitches that reduce the length of its valve leaflets. Whereas, the code also include when aortic root is also replaced using a valve conduit and coronary reconstruction. Hence, need not to code for your #2 procedure. For the procedure #5, there is no such specific code, so use CPT 33999- unlisted procedure code. Do not forget to attach the operative report with the claim form in support of unlisted procedure to avoid deduction in payment.

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