AHA Coding Clinic® for HCPCS - 2019 Issue 4; Ask the Editor

Closure of atrial septal defect with NobleStitch device

A patient presented for transcutaneous occlusion of her atrial septal defect with a NobleStitch™ suturing device. Using catheters and wires, a sizing balloon was advanced across the septum and inflated to stop color flow and allow for an angiogram to be performed. The balloon sizing catheter was exchanged for the secundum delivery system which was advanced over the wires into the right atrium. An arm with thread was opened and advanced to approximate the atrial septum with angiography confirming the position. The needle was then fired and shown to capture the suture. The system was exteriorized along with the suture ends which were then stabilized. The delivery system was then advanced into the left atrium. The needle was fired, the suture picked up and the system was exteriorized along with the two ends of the suture which were controlled along with the first suture. The sutures were loaded into the KwiKnot™ system and this was advanced to the atrial septum. Under tension with hand angiography confirming the position, the KwiKnot™ was delivered and the sutures cut. What is the CPT code for closure of an atrial septal defect with a NobleStitch™ secundum system where sutures are placed and knotted via a transcatheter approach? ...

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