AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2015 Quarter 4
Congenital Heart Corrective Procedures
An infant, who had previously undergone modified Blalock-Taussig shunt surgery secondary to transposition of the great arteries and left ventricular outflow tract obstruction, presents for complete repair. The surgeon performed a Rastelli operation (ventricular septal defect closure using Gore-Tex baffle and right ventricle (RV) to pulmonary artery (PA) bypass with a Contegra valved conduit) after placing the patient on cardiopulmonary bypass. When a valved conduit is used in the bypass procedure, is it appropriate to assign an additional code for valve replacement? How should this surgery be coded? ...
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Article Overview
This article reviews examples of congenital heart corrective procedures with a focus on ICD-10-PCS code assignment. It is aimed at coders and coding professionals working with pediatric cardiac surgery, congenital heart repairs, and Medicare/CMS-related classification guidance. The content frames procedure scenarios and the general coding issues they raise without serving as a full coding reference.
Why This Topic Matters
Congenital cardiac surgeries can involve complex operative details that affect procedure classification. This article helps readers understand the scope of the coding discussion and why these cases are under review by CMS and the ICD-10 Coordination and Maintenance Committee.
Article Sections
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Rastelli Operation
Introduces a congenital heart repair example and the coding questions associated with the operative scenario. The section centers on procedure classification issues for ICD-10-PCS and CMS review context.
What You Will Learn
- The general coding context for congenital heart corrective procedures
- How article examples are organized around ICD-10-PCS assignment questions
- Which kinds of operative scenarios are being discussed for CMS review
- Why complex pediatric cardiac repairs require careful procedure classification
Who Should Read This
- Inpatient hospital coders
- ICD-10-PCS coding professionals
- HIM specialists
- Clinical documentation improvement staff
- Pediatric cardiac surgery coding teams
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