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I am trying to distinguish the difference between the code 33411 and 33414. My surgeon says that enlarging the annulus (33411) basically means he must enlarge the LVOT as well. However, the only code I see that mentions a LVOT patch enlargement is 33414.

In this particular case the surgeon performed a 'classic' double valve double patch procedure through the left ventricular outflow tract. This is where both the aortic and mitral valves are replaced. The surgeon speaks of lowering the patch into position and then placing the valve into position. Then a patch of Dacron is placed on the exposed portion of the mitral annulus with sutures to hold it in place so that he can complete the Lt atrial closure and the septation of the ventricle from the atrium. The sutures end up closing the Lt atrium and sutures the valve into position. Then, he moves on to the aortic annulus. He says then that the patch was placed above the mitral prosthesis then onto the patch they threaded the valve. Finally, the Dacron patch that was sewn up the sides of the aorta from the mitral annulus is used to close the aortotomy.

Since I cannot find a code with a mitral valve patch I'm wondering if I should code a double patch, double valve as:


Am I totally off?:eek: