Question TAVR via transcarotid approach CPT code???

mcauffman86

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Saint Joseph, MI
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Would unlisted code 33999 be appropriate to code for a TAVR procedure done via a transcarotid approach? This is the code I seem to want to default to since there is no cpt code for a TAVR done via a transcarotid approach. The op report documentation is listed below for reference:

Procedure:
Procedure(s):
Right Transcarotid Approach Transcatheter Aortic Valve Replacement with 34mm Medtronic Evolut R Valve

Indications:
Transesophageal echo demonstrated severe aortic stenosis with moderate to severe mitral regurgitation. TAVR is recommended via the right carotid artery approach due to severe PVD.

TAVR Procedure Note

1. Arterial and venous access via right SFA artery
2. Aortic root catheter placement using a 6 french pigtail catheter
3. Aortic root angiogram to determine optimal coaxial view for TAVR
4. Surgical access of the right common carotid artery via Dr. **********
5. Insertion of a 20 fr arterial delivery sheath via the right common carotid artery
6. Left heart catheterization using an AL-1 to cross the stenotic aortic valve via the right carotid sheath
7. TAVR using a Medtronic 34mm Evolut R valve
8. Surgical repair of the right common carotid artery by Dr. ***********
9. Proglide closure of the right SFA artery
 

cpc2007

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Yes, currently transcarotid and transcaval approaches to the TAVR procedure do not have established codes and would be coded with unlisted code 33999. I am seeing this guidance from well-respected consultants in interventional cardiology, including Dr. Z of Z Health Publishing. I hope that helps!

Kim

www.codingmastery.com
 
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