AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2022 Issue 1; Ask the Editor

Repair of Common Atrioventricular Valve Using Alfieri Stitch

A 5-1/2 month-old infant, who was diagnosed with moderate-to-severe common atrioventricular (AV) valve regurgitation, underwent complex common AV valve repair. The patient was also noted to have tricuspid valve regurgitation. At surgery, a midline sternotomy was performed. Attention was directed to the common AV valve after atrial stay sutures had been placed. The common AV valve was floated with saline and there were multiple jets of regurgitation through the right-sided component of the AV valve. A series of horizontal mattress sutures were placed to pex the superior bridging leaflet to the rudimentary septal leaflet, and an Alfieri stitch was placed between the superior and inferior bridging leaflet, incorporating a portion of the septal leaflet. Upon saline testing, the valve appeared to be dramatically improved. According to Coding Clinic, Fourth Quarter 2017, pages 35-36, Alfieri stitch procedures are assigned the root operation “Restriction,” however there is no body part value for AV valve under root operation “Restriction.” What is the appropriate body part value and root operation to capture a repair of the common AV valve with sutures and Alfieri stitch? ...

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