In line with a series of changes made last year, additional changes were made to multiple code tables to enable more precise coding of procedures performed for congenital heart defects. Depending on the particular code table, these changes can involve body part values and/or qualifier values.
The procedure code tables impacted are:
Corrective Surgery for Left Ventricular Outflow Tract Obstruction
In code table 027, Heart and Great Vessels, Dilation, one body part value was added.
|L Ventricle, Left|
The left ventricular outflow tract (LVOT) is the path that blood follows from the upper portion of the left ventricle through the aortic valve and into the aorta. Obstruction within the LVOT impedes critical blood flow through this area. Obstruction is very commonly due to congenital subaortic stenosis in which an aberrant fibrous membrane is found within the left ventricle just below the aortic valve. The LVOT may also be hypoplastic, or the left ventricle may have an area of hypertrophied muscle contributing to the obstruction.
Correction of LVOT obstruction may involve removal of the subaortic membrane, myotomy of the left ventricle, or myomectomy of the left ventricle, or a combination of these procedures. Regardless of the specific technique, the objective is always to re-open and expand the LVOT to eliminate the obstruction.
The patient had left ventricular outflow tract obstruction due to a subaortic membrane as well as tubular hypoplasia of the area. Following sternotomy and aortotomy, the aortic valve leaflets were retracted to expose the area of subaortic stenosis in the left ventricle. The subaortic membrane was examined and resected in its entirety. A left ventricular myomectomy was also performed to open the outflow tract and eliminate the obstruction. What is the appropriate procedure code?
In this case, the objective of the surgery is to dilate/open the tract by removing the thickened septal wall to widen the outflow tract. Assign the following ICD-10-PCS code:
027L0ZZ Dilation of left ventricle, open approach