Bidirectional Shunting following Transseptal Puncture

A patient with symptomatic mitral regurgitation and tricuspid regurgitation presented for transcatheter valve repair with clip placement. Utilizing fluoroscopy, intracardiac echocardiography and transesophageal echocardiography (TEE), MitraClips™ were placed in both the anterior and posterior leaflets of the mitral valve following transseptal puncture. However, clip deployment into the tricuspid valve was unable to be completed. The TEE revealed the site of the transseptal puncture showed bidirectional flow. Subsequently, a bubble study was performed which showed bidirectional shunting. Therefore, it was decided to close the transseptal access site with a 25 mm Gore® Cardioform device. What is the appropriate ICD-10-CM code to capture bidirectional shunting following transseptal puncture? ...

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