Cardiology Coding Alert

Question: Which ICD-9 code applies to RV-to-PA conduit valve stenosis? The conduit required replacement.

Codify Member

Answer: If the right ventricle to pulmonary artery conduit valve had reached its expected end of life, consider V53.39 (Fitting and adjustment of other cardiac device), which applies to removal and replacement of a device.

AHA’s ICD-9-CM Coding Clinic (2008, Vol. 25, No. 2) includes a Q&A that states a device reaching its expected end of life isn’t a complication. In the Q&A, a patient has a heart valve prosthesis and documentation shows “prosthetic valve stenosis due to end of life.” Coding Clinic indicates the appropriate code would be V53.39 because the device is expected to wear out.

If the conduit hadn’t reached its expected end of life, then look at 996.71 (Other complications due to heart valve prosthesis) and 996.72 (Other complications due to other cardiac device implant and graft), depending on the nature of the conduit.

ICD-10: The ICD-10 code set, scheduled for Oct. 1, 2014, implementation, crosses V53.39 to Z45.09 (Encounter for adjustment and management of other cardiac device). ICD-10 also includes a code specific to stenosis as a complication: T82.857A (Stenosis of cardiac prosthetic devices, implants and grafts, initial encounter).