Help with ICD-9 codes for valve replacement

nbuck

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We have a patient who comes in for protimes. He had a congenital bicuspid aortic valve, now replaced with a mechanical valve due to aortic stenosis. We are using the codes 424.1, V43.3, and V58.61 for the protimes. There is debate that we should use the 746.4 code for congenital bicuspid valve, but the ICD-9 guidelines say if the problem is fixed to use the "history of" code. Should we be using the 746.4 code or the 424.1? Also, should I include the
V13.65, history of corrected congenital malformations of heart & circulatory system? What would you do? Thanks in advance!
 
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