• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below.
  • We're introducing new features and a new look to make the forums easier to use and more valuable to you. See what's new and let us know what you think!

Tavr/tavi 33361

MarieL

Networker
Messages
26
Best answers
0
I am new to coding cardio procedure/surgeries. Could someone tell me what needs to be in the medical record note to support to bill for this procedure? Or if someone could direct to where I could find some information to assist me.

Thanks in advance!
 

sandy06

Networker
Messages
61
Location
Weston, FL
Best answers
0
Hi

In order to bill for TAVR/TAVI you will need to bill with Dx Code I35.0 and Z00.6
and CPT Code 33361 with modifier 62 and Q0 on the Operative Report has to have perform by a Cardiac Surgeon and Cardiologist.
Make sure you add the NCT Number 01737528. If not Medicare will denied your claim.

Registry Approvals

STS/ACC Transcatheter Valve Therapy (TVT) Registry
ClinicalTrials.gov number: NCT01737528
https://www.ncdr.com/TVT/Home/Default.aspx


Hope this info help, good luck.
 

MarieL

Networker
Messages
26
Best answers
0
Tavr/tavi

Thanks so much for your help. Is there anything in the OP note that I need to make sure is in there in order to code this ?
 

sandy06

Networker
Messages
61
Location
Weston, FL
Best answers
0
Here is an example of one report.

PREOPERATIVE DIAGNOSIS:
Severe aortic stenosis, high risk.
**
POSTOPERATIVE DIAGNOSIS:
Severe aortic stenosis, high risk

OPERATION:
Right femoral vein transvenous pacer
wire with bilateral femoral
artery exposure, aortogram and angiogram, placement of a 23-mm TAVI
Sapien-3 balloon valvuloplasty x2, and primary repair of left common
femoral artery with a Perclose device x2.

DESCRIPTION OF PROCEDURE/FINDINGS:
The patient was identified in the holding area, placed on the table in
the supine position. Preoperative sedation and antibiotics were given
to the patient, prepped and draped in a sterile fashion. With general
anesthesia given to the patient, a transesophageal echo and
fluoroscopy were performed throughout the entire procedure. At this
point, a modified Seldinger technique was utilized, and we were able
to pass a 6-French introducer, utilizing modified social Seldinger
technique, into the right common femoral vein. At this point, a
guidewire was able to be passed without any difficulty, and we were
able to pass a temporary transvenous pacing wire to the right
ventricular apex, and secured in place with Ethibond suture, and
placed on standby. A 4-French introducer was placed as well into the
common femoral artery on the right, and a pigtail was able to be
placed into the aortic root. This was done without any difficulty.
**
At this point, we sequentially dilated the left common femoral artery
over two Perclose devices, all the way to the 14-French sheath, and
this was done without any difficulty. Heparin was given to achieve an
ACT of greater than 400. At this point, an aortic root angiogram was
performed and we were able to size what looked to be a 23-mm valve. At
this point, the valve was being prepared on the back table, and an AO1
catheter was passed through the aortic valve into the left ventricle,
and exchanged for a pigtail and the valve gradient was measured. At
this point, once the valve gradient was recorded, the pigtail was
exchanged to a long Lunderquist wire. At this point, the valve was
passed into the deliver system over the stylet, into the left
ventricle. With the heart rapidly pacing, we were able to deploy the
valve without any difficulty. The valve was completely deployed to
full diameter, and the patient tolerated this well, and remained
hemodynamically stable. There was evidence of approximately a 1+
perivalvular leak, so we deployed a valvuloplasty balloon, which was
able to be performed with a 2+ diameter extension of the valve, and
this was done without any difficulty. Once the balloon valvuloplasty
was performed, the perivalvular leak was trace. The patient tolerated
this well, and remained hemodynamically stable. All introducers and
catheters were removed, and the Perclose device was utilized to repair
the common femoral artery on the left. Protamine was given to reverse
the heparin, and the patient remained hemodynamically stable, and
tolerated this well.
 
Top