AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2022 Issue 1; Ask the Editor
Repair of Common Atrioventricular Valve Using Alfieri Stitch
A 5-1/2 month-old infant, who was diagnosed with moderate-to-severe common atrioventricular (AV) valve regurgitation, underwent complex common AV valve repair. The patient was also noted to have tricuspid valve regurgitation. At surgery, a midline sternotomy was performed. Attention was directed to the common AV valve after atrial stay sutures had been placed. The common AV valve was floated with saline and there were multiple jets of regurgitation through the right-sided component of the AV valve. A series of horizontal mattress sutures were placed to pex the superior bridging leaflet to the rudimentary septal leaflet, and an Alfieri stitch was placed between the superior and inferior bridging leaflet, incorporating a portion of the septal leaflet. Upon saline testing, the valve appeared to be dramatically improved. According to Coding Clinic, Fourth Quarter 2017, pages 35-36, Alfieri stitch procedures are assigned the root operation “Restriction,” however there is no body part value for AV valve under root operation “Restriction.” What is the appropriate body part value and root operation to capture a repair of the common AV valve with sutures and Alfieri stitch? ...
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Article Overview
This premium article explains a pediatric cardiac valve repair case involving a common atrioventricular valve and addresses how the procedure is interpreted for ICD-10-PCS reporting. It is relevant to inpatient coders, CDI specialists, and cardiac surgery coding professionals who need to understand how Coding Clinic guidance applies to this type of valve repair scenario.
Why This Topic Matters
Cardiac valve procedures can be difficult to code accurately when surgical terminology does not map cleanly to a standard body part or procedure description. This article helps readers understand the coding issue raised by a common atrioventricular valve repair case and the official guidance referenced for reporting it.
What You Will Learn
- How a common atrioventricular valve repair case is described in surgical terms
- Why this procedure raises an ICD-10-PCS coding interpretation issue
- How referenced Coding Clinic guidance relates to the reporting discussion
- What aspects of the case are clinically and procedurally relevant to coding review
Who Should Read This
- Inpatient medical coders
- Coding educators
- Clinical documentation improvement specialists
- Cardiothoracic surgery coders
- Revenue cycle professionals
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