AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2024 Issue 2; Ask the Editor

Ascending Aorta and Total Aortic Arch Repair with Extension Frozen Elephant Trunk

The patient underwent open repair of the ascending aorta and total aortic arch with an extension frozen elephant trunk. During surgery, the ascending aorta and proximal arch were excised and a GORE® conformable thoracic stent graft was advanced into the ongoing aorta and deployed in Zone 1. It was fenestrated on-table according to the branched stented anastomosis frozen elephant trunk repair (BSAFER) technique, with a Fluency™ stent graft deployed into the left subclavian artery (LSA), and a Viabahn® stent graft deployed into the left common carotid artery (LCC). The innominate artery was maintained as an island implanted directly to the graft. A Gelweave™ graft was trimmed and sewn end to end to the ongoing stented aorta. The aorta was de-aired and systemic flow resumed. Appropriate flow in the descending aorta was confirmed by transesophageal echocardiogram, and rewarming begun. The graft was then trimmed and sewn end to end to the sinotubular junction. How should this case be coded? ...

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