In code table 02L, Heart and Great Vessels, Occlusion, two body part values were added, to capture detail for embolization procedures performed on the pulmonary trunk and right pulmonary artery.
|P Pulmonary Trunk|
|Q Pulmonary Artery, Right|
In many procedures for correction of congenital heart defects, native blood flow to the pulmonary arteries is cut off as an adjunctive measure because a newly created conduit, for example from the right ventricle to the pulmonary artery, has now taken over the function of delivering blood to the pulmonary arteries.
Depending on the specific defect, this may be accomplished by occluding the pulmonary valve itself. Alternately, it may be accomplished by ligating or otherwise occluding the pulmonary trunk or, depending on the patient’s pulmonary artery anomaly, the left or right pulmonary artery. To enable more precise identification of the site being occluded, the new body part values were added to existing body part values “H” Pulmonary Valve and “R” Pulmonary Artery, Left. Other clinical scenarios such as arteriovenous fistula may also require occluding the site. Please note that these codes are also used in other situations besides correction of cardiac anomalies.
In conjunction with this change, the qualifier “Z” No Qualifier was added to the row for “R” Pulmonary Artery, Left. Previously, occlusion of the left pulmonary artery could only be coded for closure of patent ductus arteriosus.
|Z No Qualifier|
A patient with a pulmonary arteriovenous fistula presented for embolization of the right middle lobe lesions. Tornado coils were deployed into the right pulmonary artery that fed into a branch of the arteriovenous fistula. Post-embolization imaging showed complete occlusion of the AV fistula within the right middle lobe region. How should the procedure be coded?