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Thread: Coding for Hemi-Arch Replacement

  1. #1

    Smile Coding for Hemi-Arch Replacement

    AAPC: Back to School
    I'm fairly new to CT coding and am am looking for some input about how to code for a hemi-arch replacement. This is usually done with an ascending aorta graft (33860). We used to use 33870, but Dr. says it is not a transverse arch graft. Any ideas/thoughts would be greatly appreciated. Thank you.

    Found the answer! Thanks.
    Last edited by kbolton1; 01-07-2010 at 08:18 AM. Reason: Found the answer

  2. #2

    Default Hemiarch

    STS says that you should only bill 33870 "if a direct anastomosis of graft to the descending aorta with a side of graft to end of head vessel island (including the grafting or reimplantation of the brachiocephalic, left common carotid, and left subclavian arteries) anastomosis is performed. It would not be appropriate to report this code when only the lesser curve of the arch is done as part of a beveled ascending aortic graft" That is from the STS spring/summer 2006 coding newsletter. Hope that helps you.

  3. #3


    As stated above, you cannot bill for the transverse arch if the head vessels are not touched. When my surgeons do an ascending aortic graft with hemi-arch, I only bill for the AA graft (33860 or 33863 depending on whether the aortic root is replaced).

    Lisi, CPC

  4. #4


    Additional question: one of my surgeon's regularly uses a branched graft (imagine the standard graft with 3 extensions at the top for the head vessels). He wants me to use a vascular repair code for each extension attachment, but I'm more inclined to just use a 33870-22. Can anyone point me to any coding documentation that discusses this type of graft? I've contacted Maquet who makes the graft, but I haven't heard back from them, yet. Thanks for any guidance you can provide!

  5. #5


    Hi Carrie,

    I can't point you anywhere for guidance, I was just going to add my two cents. I would think the extensions are included in code 33870. If you replace the transverse arch, you have no choice but to reconnect the head vessels so this work must be included in the code already.

    Unless I have misunderstood what you are describing??

    Lisi, CPC

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