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Wiki TAVR vs. AVR

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Heartcoder09

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I've never come across this before and I need help. 2 physicians "attempted" to perform a TAVR (left and right femoral artery) but at the end of the case, they decided to proceed with an open approach aortic valve replacement. We can't bill the 33361 and 33405 because they're mutually exclusive. We can't bill the TAVR for one of the physicians because this requires 2 surgeons. Can we only bill the 33405 for the other surgeon?

I appreciate your help. Thank you!
 
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You only bill the end procedure so the open valve (33405). Code 33405 allows cosurg when supported. So if your documentation clearly shows that this was intended to be the TAVR and it turned open I would think this would help show the need for the 2 surg. Having them also document the need for both would help. Adding additional diagnosis to the claim can also help paint the picture. (Z53.39)
 
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