Wiki Pericardial patch repair pulmonary artery tear.

[donnasmurray@gmail.com]

Can someone help me find a code for pericardial patch repair of main and right pulmonary artery? My surgeon was doing a aortic root replacement and replacement of ascending aorta and hemi arch with 28 mm gel weave graft for closure of residual aortic dissection.
Pt has a hx of type A aortic dissection in 1993. There was extensive scarring between the aortic root aneurysm and the main pulmonary artery as well as the mid aorta where the old aortic graft had been found and the right pulmonary artery. The adherence and thinning out of these structures, because of the aortic anatomy lead to an extensive opening in the mainpulmonary artery that extended from the commissure between the right and left pulmonary valve cusps all the way out several centimeters onto the main rt pulmonary artery. This required extensive patch closure with a pericardial patch.

I'm thinking 35271 might be the code to use for this closure. Would appreciate if someone can tell me if I'm correct or if I'm wrong. If wrong, would appreciate your input on this one.

Thanks sooooooo very much to anyone who can help!!

 

[jewlz0879]

I agree with 35271 if it was done with bypass. There is also a section for 'Pulmonary Artery,' 33910-33926, but those codes do not seem to reflect the work done.

It's my understanding you would NOT utilize the 35201-35286 codes if the physician himself accidently creates a tear while performing the procedure. If that information is incorrect, I'd appreciate any new information and/or a link.

HTH

 

[JKENNEYHALL]

35271 states synthetic material was used, I disagree and would add a -22 to the ascending aortic dissection... you are already accounting for the patient being on bypass and paid accordingly with your dissection RVU's.

Julie Kenney-Hall, CPC