AHA Coding Clinic® for ICD-9 - 2012 Issue 1; Ask the Editor

Maze Procedure via Pericardioscopic Assistance (Convergent Procedure)

The patient is a 61-year-old male who is severely symptomatic with long-standing atrial fibrillation who has now reached chronic persistent atrial fibrillation, symptomatic with dyspnea on exertion and exhaustion. The patient is admitted to undergo a minimally invasive epicardial radiofrequency maze procedure via pericardioscopic assistance (convergent procedure) to treat his persistent atrial fibrillation. A transverse incision was made in the midline to allow digital exploration of the peritoneum. Laparoscopic ports were then passed to the left and right and entered the peritoneal cavity. A large pericardial cannula was introduced into the posterior pericardium. Then a monopolar radiofrequency probe was used to create a series of posterior left atrial lesions extending interior and posterior to the left superior and inferior pulmonary veins. Codes 37.33, Excision or destruction of other lesion or tissue of heart, Open approach; 37.34, Excision or destruction of other lesion or tissue of heart, Endovascular approach; and 37.37, Excision or destruction of other lesion or tissue of heart, Thoracoscopic approach, do not seem appropriate since this procedure appears to be performed laparoscopically. What is the appropriate procedure code assignment for minimally invasive epicardial radiofrequency maze procedure via pericardioscopic assistance? ...

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