AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2019 Issue 1; Ask the Editor

Replacement of Left Ventricular Assist Device with Retention of Outflow Graft

The patient presented with a left ventricular assist device (LVAD) pump thrombus as well as a left ventricular thrombus, and underwent LVAD replacement. At surgery, the patient was placed on cardiopulmonary bypass and redo sternotomy was performed. The outflow graft was clamped/transected and the LVAD was dissected free and explanted from the left ventricular apex. Thrombus was removed and a new LVAD was brought onto the operative field. The inflow conduit of the pump was then connected to the apical connector and secured. The driveline was connected to the driveline-tunneling device and brought through the driveline tunnel. The heart was returned to its native position; excellent seating of the pump was noted. The outflow graft was cut to the appropriate length and anastomosed to the distal remnant of the old LVAD system. The old driveline was transected and the tunnel remnant removed. What is the correct code assignment for replacement of a LVAD when the outflow graft is not replaced? ...

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