AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2018 Issue 3; Ask the Editor

Decommissioning of Left Ventricular Assist Device with Exploration of Mediastinum

A patient with non-ischemic cardiomyopathy, and end-stage systolic heart failure, is status post implantation of a left ventricular assist device (LVAD). The patient’s heart recovered over time and she is now scheduled for elective decommissioning of the LVAD, by ligating the outflow-graft and cutting the driveline. During surgery, an incision was made down to the outflow graft of the pump, in the mediastinum underneath the sternum and the mediastinal area was explored. The outflow-graft was tied, pump support was reduced to no forward flow, and the outflow graft was ligated and shut down. Next, the driveline exit site was excised and the driveline was tunneled subcutaneously via the trunk and cut from the exit site. The cable and the exit site were closed. What is the correct code assignment for decommissioning of the LVAD by ligating the outflow-graft and cutting the driveline? ...

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