AHA Coding Clinic® for ICD-9 - 2004 Issue 1; Ask the Editor

Pulmonary Homograft Surgery Status Post Tetralogy of Fallot Repair

This 8-year old patient was admitted to our facility with a diagnosis of tetralogy of Fallot, which was repaired six years ago. The patient now presents with right ventricular outflow obstruction, pulmonary insufficiency, significant hypoplasia and takeoff stenosis of the left pulmonary artery. She is referred for operative repair. The patient underwent a right ventricular outflow tract reconstruction with a 25-mm pulmonary homograft; a left pulmonary artery reconstruction out to hilum with enlarging patch arterioplasty; a right pulmonary artery takeoff stenosis arterioplasty; cardiopulmonary bypass and intraoperative transesophageal echocardiogram. What is the proper coding and sequencing of the diagnoses and procedures for this case? ...

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