AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2017 Issue 3; Ask the Editor
Senning Procedure (Atrial Switch)
A pediatric patient with transposition of the great arteries (TGA) presented for Senning procedure, in which a baffle or flap of atrial tissue is created to direct blood flow to the pulmonary veins, in order to correct the defect. During surgery, the patient was placed on cardiopulmonary bypass, and a portion of the anterior pericardium was excised to use as patches. The left and right atria were incised and a baffle was created using the pericardial tissue as a supplement. The creation of the baffle allows the pulmonary venous blood to be redirected to the tricuspid valve and the superior and inferior vena caval blood to be redirected to the mitral valve. Based on the use of the pericardial tissue for augmentation, would the correct root operation for this procedure be “Supplement?” Would the harvesting of the graft be separately coded? ...
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Article Overview
This premium article addresses coding for a Senning procedure in a pediatric patient with transposition of the great arteries. It focuses on the ICD-10-PCS classification of the operative approach, tissue use, and whether related harvesting or graft work is reported separately. The article is intended for coders working with congenital cardiac surgery and inpatient procedural coding.
Why This Topic Matters
Atrial switch procedures can be difficult to classify in ICD-10-PCS because they involve multiple operative steps, tissue manipulation, and complex cardiac anatomy. Understanding the coding framework helps inpatient coders and CDI professionals apply the correct procedural logic for congenital heart surgery documentation.
What You Will Learn
- How this congenital cardiac procedure is characterized for ICD-10-PCS coding purposes
- How tissue use and procedural components are considered in inpatient procedure reporting
- Whether related work performed during the operation is treated separately in coding analysis
- How the article frames coding questions for a Senning atrial switch case
Who Should Read This
- Inpatient medical coders
- Cardiac surgery coders
- Clinical documentation integrity specialists
- Coding educators
- Revenue cycle professionals
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