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AHA Coding Clinic® for ICD-9 - 2007 Issue 1; Ask the Editor

Unifocalization of Pulmonary Arteries

A patient presents with pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries with confluent right and left pulmonary artery, and large major aortopulmonary collateral arteries (MAPCAs) to the right lower lobe, left lower lobe and right upper lobe. Complete single stage repair of pulmonary atresia with ventricular septal defect and MAPCAs with bilateral pulmonary unifocalization and closure of the ventricular septal defect and placement of right ventricle to pulmonary artery conduit was performed. Continuity was reestablished between the right ventricle and the pulmonary artery using a cryopreserved 9 mm pulmonary artery homograft, which was sutured to the pulmonary artery bifurcation. A 10 mm Gore-tex tube was then used to attach the proximal aspect of this homograft to the right ventriculotomy. Is code 35.25, Replacement of pulmonary valve with tissue graft appropriate for this procedure? What are the appropriate procedure code assignments for unifocalization of the pulmonary arteries? ...

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