Wiki Aortic valve replacement with ascending aortic reinforcement

[hannahm]

I have a doctor performing the following procedures:

1. Aortic valve replacement, with stentless valve aortic prosthesis
2. Ascending aortic reinforcement with Hemashield graft

I'm thinking to use 33405 for the valve replacement but not so sure about the reinforcement. The operative note reads "It was necessary to reinforce the ascending aorta due to the weak thin aorta. We used three segments of Hemashield graft, that were sutured with two figure of U stitches of Ethibond."

I'm leaning toward 33335: insertion of graft, aorta or great vessels; with cardiopulmonary bypass. Any suggestions would be greatly appreciated!

 

[lisigirl]

CPT code 33335 is supposed to be used when repairing a traumatic injury to the aorta. I believe a "thinning wall" of the aorta is the start of an aneurysm so it may be appropriate to use CPT 33860. Maybe you should ask the surgeon what he/she thinks.

Also, for a stentless aortic valve, use CPT 33410. These valves are sutured directly to the aortic wall rather than the valve annulus.

Lisi, CPC
eharkler@nmh.org