STS Primary Procedure Descriptions

Name Description
PFO, Primary closure  Suture closure of patent foramen ovale (PFO).
ASD repair, Primary closure  Suture closure of secundum (most frequently), coronary sinus, sinus venosus or common atrium ASD.
ASD repair, Patch  Patch closure (using any type of patch material) of secundum, coronary sinus, or sinus venosus ASD.
ASD repair, Device  Closure of any type ASD (including PFO) using a device.
ASD repair, Patch + PAPVC repair  Patch closure (using any type of patch material) of secundum, coronary sinus, or sinus venosus ASD plus PAPVC repair, any type
ASD, Common atrium (single atrium), Septation Septation of common (single) atrium using any type patch material.
ASD creation/enlargement  Creation of an atrial septal defect or enlargement of an existing atrial septal defect using a variety of modalities including balloon septostomy, blade septostomy, or surgical septectomy. Creation may be accomplished with or without use of cardiopulmonary bypass.
ASD partial closure  Intentional partial closure of any type ASD (partial suture or fenestrated patch closure).
Atrial septal fenestration  Creation of a fenestration (window) in the septum between the atrial chambers. Usually performed using a hole punch, creating a speci fically sized communication in patch material placed on the atrial septum.
Atrial fenestration closure  Closure of previously created atrial fenestration using any method including device, primary suture, or patch.
VSD repair, Primary closure  Suture closure of any type VSD.
VSD repair, Patch  Patch closure (using any type of patch material) of any type VSD.
VSD repair, Device  Closure of any type VSD using a device.
VSD, Multiple, Repair Closure of more than one VSD using any method or combination of methods. Further information regarding each type of VSD closed and method of closure can be provided by additionally listing specifics for each VSD losed. In the case of multiple VSDs in which only one is closed the procedure should be coded as closure of a single VSD. The fundamental diagnosis, in this case, would be ?VSD, Multiple? and a secondary diagnosis can be the morphological type of VSD that was closed at the time of surgery.
VSD creation/enlargement  Creation of a ventricular septal defector enlargement ofan existing ventricular septal defect.
Ventricular septal fenestration  Creation of a fenestration (window) in the septum between the ventricular chambers. Usually performed using a hole punch, creating a specifically sized communication in patch material placed on the ventricular septum.
AVC (AVSD) repair, Complete (CAVSD)  Repair of complete AV canal (AVSD) using one- or two-patch or other technique, with or without mitral valve cleft repair.
AVC (AVSD) repair, Intermediate (Transitional)  Repair of intermediate AV canal (AVSD) using ASD and VSD patch, or ASD patch and VSD suture, or other technique, with or without mitral valve cleft repair.
AVC (AVSD) repair, Partial (Incomplete) (PAVSD)  Repair of partial AV canal defect (primum ASD), any technique, with or without repair of cleft mitral valve.
Valvuloplasty, Common atrioventricular valve  Common AV valve repair, any type
Valvuloplasty converted to valve replacement in the same operation, Common atrioventricular valve  Common AV valve repair attempted, converted to valve replacement with prosthetic valve during the same operation.
Valve replacement, Common atrioventricular valve  Replacement of the common AV valve with a prosthetic valve.
AP window repair  Repair of AP window using one- or two-patch technique with cardiopulmonary bypass
Pulmonary artery origin from ascending aorta (hemitruncus) repair  Repair of pulmonary artery origin from the ascending aorta by direct reimplantation, autogenous flap, or conduit, with or without use of cardiopulmonary bypass.
Truncus arteriosus repair  Truncus arteriosus repair that most frequently includes patch VSD closure and placement of a conduit from RV to PA. In some cases, a conduit is not placed but an RV to PA connection is made by direct association. Very rarely, there is no VSD to be closed. Truncal valve repair or replacement should be coded separately (Valvuloplasty, Truncal valve, Valve replacement, Truncal valve), as would be the case as well with associated arch anomalies requiring repair (e.g., Interrupted aortic arch repair).
Valvuloplasty, Truncal valve Truncal valve repair, any type.
Valvuloplasty converted to valve replacement in the same operation, Truncal valve  Truncal valve repair attempted, converted to valve replacement with prosthetic valve during the same operation.
Valve replacement, Truncal valve  Replacement of the truncal valve with a prosthetic valve.
Truncus + Interrupted aortic arch repair (IAA) repair  Truncus arteriosus repair usually includes patch VSD closure and placement of a conduit from RV to PA. In some cases, a conduit is not placed but an RV to PA connection is made by direct association. (Very rarely, there is no VSD) plus repair of interrupted aortic arch.
PAPVC repair  PAPVC repair revolves around whether an intracardiac baffle is created to redirect pulmonary venous return to the left atrium or if the anomalous pulmonary vein is translocated and connected to the left atrium directly. If there is an associated ASD and it is closed, that procedure should also be listed.
PAPVC, Scimitar, Repair  In scimitar syndrome, PAPVC repair also revolves around whether an intracardiac baffle is created to redirect pulmonary venous return to the left atrium or if the anomalous pulmonary vein is translocated and connected to the left atrium directly. If there is an associated ASD and it is closed, that procedure should also be listed. Occasionally an ASD is created
PAPVC repair, Baffle redirection to left atrium with systemic vein translocation  An intracardiac baffle is created to redirect pulmonary venous return to the left atrium and SVC sewn to right atrial appendage).
TAPVC repair  Repair of TAPVC, any type. Issues surrounding TAPVC repair involve how the main pulmonary venous confluence anastomosis is fashioned, whether an associated ASD is closed or left open or enlarged (ASD closure and enlargement may be listed separately), and whether, particularly in mixed type TAPVC repair, an additional anomalous pulmonary vein is repaired surgically.
TAPVC repair + Shunt - systemic-to-pulmonary  Repair of TAPVC, any type plus a systemic to pulmonary shunt creation.
Cor triatriatum repair  Repair of cor triatriatum. Surgical decision making revolves around the approach to the membrane creating the cor triatriatum defect, how any associated ASD is closed, and how any associated anomalous pulmonary vein connection is addressed. Both ASD closure and anomalous pulmonary venous connection may be listed as separate procedures.
Pulmonary venous stenosis repair  Repair of pulmonary venous stenosis, whether congenital or acquired. Repair can be accomplished with a variety of approaches: sutureless, patch venoplasty, stent placement, etc.
Atrial baffle procedure (non-Mustard, non-Senning)  The atrial baffle procedure code is used primarily for repair of systemic venous anomalies, as in redirection of left superior vena cava drainage to the right atrium.
Anomalous systemic venous connection repair  With the exception of atrial baffle procedures (harvest code 310), anomalous systemic venous connection repair includes a range of surgical approaches, including, among others, ligation of anomalous vessels, reimplantation of anomalous vessels (with or without use of a conduit), or redirection of anomalous systemic venous flow through directly to the pulmonary circulation (bidirectional Glenn to redirect LSVC or RSVC to left or right pulmonary artery, respectively).
Systemic venous stenosis repair  Stenosis or obstruction of a systemic vein (most commonly SVC or IVC) may be relieved with patch or conduit placement, excision of the stenotic area with primary reanastomosis or direct reimplantation.
TOF repair, No ventriculotomy  Tetralogy of Fallot repair (assumes VSD closure and relief of pulmonary stenosis at one or more levels), without use of an incision in the infundibulum of the right ventricle for exposure. In most cases this would be a transatrial and transpulmonary artery approach to repair the VSD and relieve the pulmonary stenosis. If the main pulmonary artery incision is extended proximally through the pulmonary annulus, this must be considered "transannular" and thus a ventricular incision, though the length of the incision onto the ventricle itself may be minimal.
TOF repair, Ventriculotomy, Nontransanular patch  Tetralogy of Fallot repair (assumes VSD closure and relief of pulmonary stenosis at one or more levels), with use of a ventriculotomy incision, but without placement of a trans-pulmonary annulus patch. If the main pulmonary artery incision is extended proximally through the pulmonary annulus, this must be considered "transannular" and thus a ventricular incision, though the length of the incision onto the ventricle itself may be minimal.
TOF repair, Ventriculotomy, Transanular patch  Tetralogy of Fallot repair (assumes VSD closure and relief of pulmonary stenosis at one or more levels), with use of a ventriculotomy incision and placement of a trans-pulmonary annulus patch. If the main pulmonary artery incision is extended proximally through the pulmonary annulus, this must be considered "transannular" and thus a ventricular incision, though the length of the incision onto the ventricle itself may be minimal.
TOF repair, RV-PA conduit  Tetralogy of Fallot repair (assumes VSD closure and relief of pulmonary stenosis at one or more levels), with placement of a right ventricle-to-pulmonary artery conduit. In this procedure the major components of pulmonary stenosis are relieved with placement of theR V-PA conduit.
TOF - AVC (AVSD) repair  Tetralogy of Fallot repair (assumes VSD closure and relief of pulmonary stenosis at one or more levels), with repair of associated AV canal defect. Repair of associated atrial septal defect or atrioventricular valve repair(s) should be listed as additional or secondary procedures under the primary TOF-AVC procedure.
TOF - Absent pulmonary valve repair  Repair of tetralogy of Fallot with absent pulmonary valve complex. In most cases this repair will involve pulmonary valve replacement (pulmonary or aortic homograft, porcine, other) and reduction pulmonary artery arterioplasty.
Pulmonary atresia - VSD (including TOF, PA) repair  For patients with pulmonary atresia with ventricular septal defect without MAPCAs, including those with tetralogy of Fallot with pulmonary atresia, repair may entail either a tetralogy-like repair with transannular patch placement, a VSD closure with placement of an RV-PA conduit, or an intraventricular tunnel VSD closure with transannular patch or RV-PA conduit placement. To assure an accurate count of repairs of pulmonary atresia-VSD without MAPCAs, even if a tetralogy-type repair or Rastelli-type repair is used, the pulmonary atresia-VSD code should be the code used, not Rastelli procedure or tetralogy of Fallot repair with transannular patch.
Pulmonary atresia - VSD - MAPCA repair Complete single stage repair  (1-stage repair that includes bilateral pulmonary unifocalization + VSD closure + RV to PA connection [with or without conduit]).
Pulmonary atresia - VSD - MAPCA repair Status post prior complete unifocalization  (includes VSD closure + RV to PA connection [with or without conduit]) VSD closure + RV to PA connection [with or without conduit]).
Pulmonary atresia - VSD - MAPCA repair Status post prior Incomplete unifocalization  (includes completion of pulmonary unifocalization + VSD closure + RV to PA connection [with or without conduit]) Completion of pulmonary unifocalization + VSD closure + RV to PA connection [with or without conduit])Pulmonary atresia - VSD - MAPCA repair, status post prior incomplete unifocalization.
Unifocalization MAPCA(s) (complete)  Bilateral pulmonary unifocalization - Complete unifocalization (all usable MAPCA[s] are incorporated) Complete unifocalization , all usable MAPCA[s] are incorporated.
Unifocalization MAPCA(s) (incomplete)  Bilateral pulmonary unifocalization - Incomplete unifocalization (not all usable MAPCA[s] are incorporated) Incomplete unifocalization, not all usable MAPCA[s] are incorporated.
Unifocalization MAPCA(s) (unilateral)  Unilateral pulmonary unifocalization MAPCA(s), Unilateral pulmonary unifocalization (oneside).
Unifocalization MAPCA(s)  Anastomosis of aortopulmonary collateral arteries into the left, right, or main pulmonary artery or into a tube graft or other type of confluence. The unifocalization procedure may be done on or off bypass.
Occlusion of MAPCA(s)  Occlusion, or closing off, of MAPCAs. This may be done with a transcatheter occluding device, usually a coil, or by surgical techniques.
Valvuloplasty, Tricuspid  Reconstruction of the tricuspid valve may include but not be limited to a wide range of techniques including, leaflet patch extension, artificial chordae placement, and papillary muscle translocation with or without detachment. Annuloplasty techniques that may be done solely or in combination with leaflet, chordae or muscle repair to achieve a competent valve include: eccentric annuloplasty, Kay annular plication, purse-string annuloplasty (including semicircular annuloplasty), sliding annuloplasty, and annuloplasty with ring placement. Do not use this code if tricuspid valve malfunction is secondary to Ebstein's anomaly
Valvuloplasty converted to valve replacement in the same operation, Tricuspid  Tricuspid valve repair attempted, converted to valve replacement with prosthetic valve during the same operation.
Ebstein's repair  To assure an accurate count of repairs of Ebstein's anomaly of the tricuspid valve, this procedure code was included. Repair of Ebstein's anomaly may include, among other techniques, repositioning of the tricuspid valve, plication of the atrialized right ventricle, or right reduction atrioplasty. Often associated ASD's may be closed and arrhythmias addressed with surgical ablation procedures. These procedures should be entered as separate procedure codes.
Valve replacement, Tricuspid (TVR)  Replacement of the tricuspid valve with a prosthetic valve.
Valve closure, Tricuspid (exclusion, univentricular approach)  In a functional single ventricle heart, the tricuspid valve may be closed using a patch, thereby excluding the RV. Tricuspid valve closure may be used for infants with Ebstein's anomaly and severe tricuspid regurgitation or in patients with pulmonary atresia-intact ventricular septum with sinusoids.
Valve excision, Tricuspid (without replacement)  Excision of the tricuspid valve without placement of a prosthetic valve.
Valve surgery, Other, Tricuspid  Other tricuspid valve surgery not specified in procedure codes.
RVOT procedure  Included in this procedural code would be all RVOT procedures not elsewhere specified in the nomenclature system. These might be, among others: resection of subvalvar pulmonary stenosis (not DCRV type
1 1/2 ventricular repair  Partial biventricular repair
PA, reconstruction (plasty), Main (trunk)  Reconstruction of the main pulmonary artery trunk commonly using patch material. If balloon angioplasty is performed or a stent is placed in the main pulmonary artery intraoperatively, this code may be used in addition to the balloon dilation or stent placement code. If MPA reconstruction is performed with PA debanding, both codes should be listed.
PA, reconstruction (plasty), Branch, Central (within the hilar bifurcation)  Reconstruction of the right or left branch (or both right and left) pulmonary arteries (within the hilarbifurcation) commonly using patch material. If balloon angioplasty is performed or a stent is placed in the right or left (or both) pulmonary artery intraoperatively, this code may be used in addition to the balloon dilation or stent placement code. If, rarely, branch PA banding (single or bilateral) was performed in the past and reconstruction is performed associated with debanding, both codes should be listed.
PA, reconstruction (plasty), Branch, Peripheral (at or beyond the hilar bifurcation)  Reconstruction of the peripheral right or left branch (or both right and left) pulmonary arteries (at or beyond the hilar bifurcation) commonly using patch material. If balloon angioplasty is performed or a stent is placed in the right or left (or both) peripheral pulmonary artery intraoperatively, this code may be used in addition to the balloon dilation or stent placement code.
DCRV repair  Surgical repair of DCRV combines relief of the low infundibular stenosis (via muscle resection) and closure of a VSD when present. A ventriculotomy may be required and is repaired by patch enlargement of the infundibulum. VSD closure and patch enlargement of the infundibulum, if done, should be listed as separate procedure codes.
Valvuloplasty, Pulmonic  Valvuloplasty of the pulmonic valve may include a range of techniques including but not limited to: valvotomy with or without bypass, commissurotomy, and valvuloplasty.
Valvuloplasty converted to valve replacement in the same operation, Pulmonic  Pulmonic valve repair attempted, converted to valve replacement with prosthetic valve during the same operation.
Valve replacement, Pulmonic (PVR)  Replacement of the pulmonic valve with a prosthetic valve. Care must be taken to differentiate between homograft pulmonic valve replacement and placement of a homograft RV-PA conduit.
Valve excision, Pulmonary (without replacement)  Excision of the pulmonary valve without placement of a prosthetic valve.
Valve closure, Semilunar  Closure of a semilunar valve (pulmonic or aortic) by any technique.
Valve surgery, Other, Pulmonic  Other pulmonic valve surgery not specified in procedure codes.
Conduit placement, RV to PA  Placement of a conduit, any type, from RV to PA.
Conduit placement, LV to PA  Placement of a conduit, any type, from LV to PA.
Conduit placement, Ventricle to aorta  Placement of a conduit from the right or left ventricle to the aorta.
Conduit placement, Other  Placement of a conduit from any chamber or vessel to any vessel, valved or valveless, not listed elsewhere.
Conduit reoperation  Conduit reoperation is the code to be used in the event of conduit failure, in whatever position (LV to aorta, LV to PA, RA to RV, RV to aorta, RV to PA, etc.), and from whatever cause (somatic growth, stenosis, insufficiency, infection, etc.).
Valvuloplasty, Aortic  Valvuloplasty of the aortic valve for stenosis and/or insufficiency including, but not limited to the following techniques: valvotomy (open or closed), commissurotomy, aortic valve suspension, leaflet (left, right or noncoronary) partial resection, reduction, or leaflet shaving, extended valvuloplasty (freeing of leaflets, commissurotomy, and extension of leaflets using autologous or bovine pericardium), or annuloplasty (partial - interrupted or noncircumferential sutures, or complete - circumferential sutures).
Valvuloplasty converted to valve replacement in the same operation, Aortic  Aortic valve repair attempted, converted to valve replacement with prosthetic valve during the same operation.
Valvuloplasty converted to valve replacement in the same operation, Aortic ? with Ross procedure  Aortic valve repair attempted, converted to valve replacement with a pulmonary autograft and replacement of the pulmonary valve with a homograft conduit during the same operation.
Valvuloplasty converted to valve replacement in the same operation, Aortic ? with Ross-Konno procedure  Aortic valve repair attempted, converted to Konno aortoventriculoplasty using a pulmonary autograft root for the aortic root replacement.
Valve replacement, Aortic (AVR)  Replacement of the aortic valve with a prosthetic valve (mechanical, bioprosthetic, or homograft). Use this code only if type of valve prosthesis is unknown or does not fit into the specific valve replacement codes available. Autograft valve replacement should be coded as a Ross procedure.
Valve replacement, Aortic (AVR), Mechanical  Replacement of the aortic valve with a mechanical prosthetic valve.
Valve replacement, Aortic (AVR), Bioprosthetic  Replacement of the aortic valve with a bioprosthetic prosthetic valve.
Valve replacement, Aortic (AVR), Homograft  Replacement of the aortic valve with a homograft prosthetic valve.
Aortic root replacement, Bioprosthetic  Replacement of the aortic root (that portion of the aorta attached to the heart, it gives rise to the coronary arteries) with a bioprosthesis (e.g., porcine) in a conduit, often composite.
Aortic root replacement, Mechanical  Replacement of the aortic root (that portion of the aorta attached to the heart
Aortic root replacement, Homograft  Replacement of the aortic root (that portion of the aorta attached to the heart
Aortic root replacement, Valve sparing  Replacement of the aortic root (that portion of the aorta attached to the heart
Ross procedure  Replacement of the aortic valve with a pulmonary autograft and replacement of the pulmonary valve with a homograft conduit.
Konno procedure  Relief of left ventricular outflow tract obstruction associated with aortic annular hypoplasia, aortic valvar stenosis and/or aortic valvar insufficiency via Konno aortoventriculoplasty. Components of the surgery include a longitudinal incision in the aortic septum, a vertical incision in the outflow tract of the right ventricle to join the septal incision, aortic valve replacement, and patch reconstruction of the outflow tracts of both ventricles.
Ross-Konno procedure  Relief of left ventricular outflow tract obstruction associated with aortic annular hypoplasia, aortic valvar stenosis and/or aortic valvar insufficiency via Konno aortoventriculoplasty using a pulmonary autograft root for the aortic root replacement.
Other annular enlargement procedure  Techniques included under this procedure code include those designed to effect aortic annular enlargement that are not included in other procedure codes. These include the Manouguian and Nicks aortic annular enlargement procedures.
Aortic stenosis, Subvalvar, Repair  Subvalvar aortic stenosis repair by a range of techniques including excisi on, excision and myotomy, excision and myomectomy, myotomy, myomectomy, initial placement of apical-aortic conduit (LV to aorta conduit replacement would be coded as conduit reoperation) , Vouh‚ aortoventriculoplasty (aortic annular incision at commissure of left and right coronary cusps is carried down to the septum and RV infundibulum
Aortic stenosis, Subvalvar, Repair, With myectomy for IHSS  Subvalvar aortic stenosis repair including excision and myectomy.
Aortic stenosis, Supravalvar, Repair  Repair of supravalvar aortic stenosis involving all techniques of patch aortoplasty and aortoplasty involving the use of all autologous tissue. In simple patch aortoplasty a diamond-shaped patch may be used, in the Doty technique an extended patch is placed (Y-shaped patch, incision carried into two sinuses), and in the Brom repair the ascending aorta is transected, any fibrous ridge is resected, and the three sinuses are patched separately.
Valve surgery, Other, Aortic  Other aortic valve surgery not specified in other procedure codes.
Sinus of Valsalva, Aneurysm repair  Sinus of Valsalva aneurysm repair can be organized by site of aneurysm (left, right or noncoronary sinus), type of repair (suture, patch graft, or root repair by tube graft or valved conduit), and approach used (from chamber of origin (aorta) or from chamber of penetration (LV, RV, PA, left or right atrium, etc.). Aortic root replacement procedures in association with sinus of Valsalva aneurysm repairs are usually for associated uncorrectable aortic insufficiency or multiple sinus involvement and the aortic root replacement procedure should also be listed. Additional procedures also performed at the time of sinus of Valsalva aneurysm repair include but are not limited to VSD closure, repair or replacement of aortic valve, and coronary reconstruction
LV to aorta tunnel repair  LV to aorta tunnel repair can be accomplished by suture, patch, or both, and may require reimplantation of the right coronary artery. Associated coronary artery procedures should be coded separately from the LV to aorta tunnel repair.
Valvuloplasty, Mitral  Repair of mitral valve including, but not limited to valvotomy (closed or open heart), cleft repair, annuloplasty with or without ring, chordal reconstruction, commissuorotomy, leaflet repair, or papillary muscle repair.
Valvuloplasty converted to valve replacement in the same operation, Mitral  Mitral valve repair attempted, converted to valve replacement with prosthetic valve during the same operation.
Mitral stenosis, Supravalvar mitral ring repair  Supravalvar mitral ring repair.
Valve replacement, Mitral (MVR)  Replacement of mitral valve with prosthetic valve, any kind, in suprannular or annular position.
Valve surgery, Other, Mitral  Other mitral valve surgery not specified in procedure codes.
Norwood procedure  The Norwood operation is synonymous with the term 'Norwood (Stage 1)' and is defined as an aortopulmonary connection and neoaortic arch construction resulting in univentricular physiology and pulmonary blood flow controlled with a calibrated systemic-to-pulmonary artery shunt, or a right ventricle to pulmonary artery conduit, or rarely, a cavopulmonary connection. When coding the procedure ?Norwood procedure?, the primary procedure of the operation should be ?Norwood procedure?. The second procedure that is coded as part of the Norwood (Stage 1) operation (Procedure 2 after the Norwood procedure) must then document the source of pulmonary blood flow and be chosen from the following eight choices...1. Shunt, Systemic to pulmonary, Modified Blalock-Taussig Shunt (MBTS) 2. Shunt, Systemic to pulmonary, Central (from aorta or to main pulmonary artery) 3. Shunt, Systemic to pulmonary, Other 4. Conduit placement, RV to PA 5. Bidirectional cavopulmonary anastomosis (BDCPA) (bidirectional Glen) 6. Glenn (unidirectional cavopulmonary anastomosis) (unidirectional Glenn) 7. Bilateral bidirectional cavopulmonary anastomosis (BBDCPA) (bilateral bidirectional Glenn) 8. HemiFontan.
HLHS biventricular repair  Performed in patients who have small but adequately sized ventricles to support systemic circulation. These patients usually have small, but not stenotic, aortic and/or mitral valves. Primary biventricular repair has consisted of extensive aortic arch and ascending aorta enlargement with a patch, closure of interventricular and interatrial communications, and conservative approach for left ventricular outflow tract obstruction (which may include mitral stenosis at any level, subaortic stenosis, aortic stenosis, aortic arch hypoplasia, coarctation, or interrupted aortic arch). Concurrent operations (e.g., coarctation repair, aortic valve repair or replacement, etc.) can be coded separately within the database.
Conduit insertion right ventricle to pulmonary artery  + Intraventricular tunnel left ventricle to neoaorta + Arch reconstruction (Rastelli and Norwood type arch reconstruction) (Yasui).
Hybrid Approach "Stage 1", Application of RPA & LPA bands  A ?Hybrid Procedure? is defined as a procedure that combines surgical and transcatheter interventional approaches. The term ?Hybrid approach? is used somewhat differently than the term ?Hybrid Procedure?. A ?Hybrid approach? is defined as any of a group of procedures that fit into the general silo of procedures developed from the combined use of surgical and transcatheter interventional techniques. Therefore, not all procedures classified as ?Hybrid approach? are truly ?Hybrid Procedures?.
Hybrid Approach "Stage 1", Stent placement in arterial duct (PDA)  A ?Hybrid Procedure? is defined as a procedure that combines surgical and transcatheter interventional approaches. The term ?Hybrid approach? is used somewhat differently than the term ?Hybrid Procedure?. A ?Hybrid approach? is defined as any of a group of procedures that fit into the general silo of procedures developed from the combined use of surgical and transcatheter interventional techniques. Therefore, not all procedures classified as ?Hybrid approach? are truly ?Hybrid Procedures?.
Hybrid Approach "Stage 1", Stent placement in arterial duct (PDA) + application of RPA & LPA bands  A ?Hybrid Procedure? is defined as a procedure that combines surgical and transcatheter interventional approaches. The term ?Hybrid approach? is used somewhat differently than the term ?Hybrid Procedure?. A ?Hybrid approach? is defined as any of a group of procedures that fit into the general silo of procedures developed from the combined use of surgical and transcatheter interventional techniques. Therefore, not all procedures classified as ?Hybridapproach? are truly ?Hybrid Procedures?.
Hybrid approach "Stage 2", Aortopulmonary amalgamation + Superior Cavopulmonary anastomosis(es) + PA Debanding + Aortic arch repair (Norwood [Stage 1] + Superior Cavopulmonary anastomosis(es) + PA Debanding)  A ?Hybrid Procedure? is defined as a procedure that combines surgical and transcatheter interventional approaches. The term ?Hybrid approach? is used somewhat differently than the term ?Hybrid Procedure?. A ?Hybrid approach? is defined as any of a group of procedures that fit into the general silo of procedures developed from the combined use of surgical and transcatheter interventional techniques. Therefore, not all procedures classified as ?Hybrid approach? are truly ?Hybrid Procedures?. It should be acknowledged that a Hybrid approach "Stage 2" (Aortopulmonary amalgamation + Superior Cavopulmonary anastomosis(es) + PA Debanding, with or without Aortic arch repair) gets its name not because it has any actual hybrid elements, but because it is part of a planned staged approach that is typically commenced with a hybrid procedure.
Hybrid approach "Stage 2", Aortopulmonary amalgamation + Superior Cavopulmonary anastomosis(es) + PA Debanding + Without aortic arch repair  A ?Hybrid Procedure? is defined as a procedure that combines surgical and transcatheter interventional approaches. The term ?Hybrid approach? is used somewhat differently than the term ?Hybrid Procedure?. A ?Hybrid approach? is defined as any of a group of procedures that fit into the general silo of procedures developed from the combined use of surgical and transcatheter interventional techniques. Therefore, not all procedures classified as ?Hybridapproach? are truly ?Hybrid Procedures?. It should be acknowledged that a Hybrid approach "Stage 2" (Aortopulmonary amalgamation + Superior Cavopulmonary anastomosis(es) + PA Debanding, with or without Aortic arch repair) gets its name not because it has any actual hybrid elements, but because it is part of a planned staged approach that is typically commenced with a hybrid procedure.
Hybrid Approach, Transcardiac balloon dilation  
Hybrid Approach, Transcardiac transcatheter device placement
Transplant, Heart  Heart transplantation, any technique, allograft or xenograft.
Transplant, Heart and lung  Heart and lung (single or double) transplantation.
Partial left ventriculectomy (LV volume reduction surgery) (Batista)  Wedge resection of LV muscle, with suturing of cut edges together, to reduce LV volume.
Pericardial drainage procedure  Pericardial drainage can include a range of therapies including, but not limited to: pericardiocentesis, pericardiostomy tube placement, pericardial window creation, and open pericardial drainage (pericardiotomy).
Pericardiectomy  Surgical removal of the pericardium.
Pericardial procedure, Other  Other pericardial procedures that include, but are not limited to: pericardial reconstruction for congenital absence of the pericardium, pericardial biopsy, pericardial mass or cyst excision.
Fontan, Atrio-pulmonary connection  The atrio-pulmonary Fontan is a type of Fontan with connection of the atrium to the pulmonary artery. ?The Fontan? is defined as an operation or intervention that results in caval flow from both the upper and lower body draining to the pulmonary circulation in a patient with a functionally univentricular heart.
Fontan, Atrio-ventricular connection  The atrio-ventricular Fontan is a type of Fontan with atrio-ventricular connection, either direct or with RA-RV conduit, valved or nonvalved. "The Fontan" is defined as an operation or intervention that results in caval flow from both the upper and lower body draining to the pulmonary circulation in a patient with a functionally univentricular heart.
Fontan, TCPC, Lateral tunnel, Fenestrated  The lateral tunnel Fontan is a TCPC type of Fontan Procedure created with anastomosis of SVC and right atrium to the branch pulmonary artery and an intra-atrial baffle to direct IVC flow to pulmonary artery. ?The Fontan? is defined as an operation or intervention that results in caval flow from both the upper and lower body draining to the pulmonary circulation in a patient with a functionally univentricular heart. A ?TCPC? is a Fontan where both the superior caval vein and the inferior caval vein are connected to the pulmonary circulation through separate connections that are either direct connections or tubular pathways. A fenestration of a Fontan is defined as a communication that is created to allow flow of blood between the systemic and pulmonary venous chambers.
Fontan, TCPC, Lateral tunnel, Nonfenestrated  The lateral tunnel Fontan is a TCPC type of Fontan Procedure created with anastomosis of SVC and right atrium to the branch pulmonary artery and an intra-atrial baffle to direct IVC flow to pulmonary artery. ?The Fontan? is defined as an operation or intervention that results in caval flow from both the upper and lower body draining to the pulmonary circulation in a patient with a functionally univentricular heart. A ?TCPC? is a Fontan where both the superior caval vein and the inferior caval vein are connected to the pulmonary circulation through separate connections that are either direct connections or tubular pathways. A fenestration of a Fontan is defined as a communication that is created to allow flow of blood between the systemic and pulmonary venous chambers.
Fontan, TCPC, External conduit, Fenestrated  The external conduit Fontan is a TCPC type of Fontan operation created with anastomosis of SVC to the branch pulmonary artery a conduit outside of the heart to connect the infradiaphragmatic systemic venous return to the pulmonary artery. ?The Fontan? is defined as an operation or intervention that results in caval flow from both the upper and lower body draining to the pulmonary circulation in a patient with a functionally univentricular heart. A ?TCPC? is a Fontan where both the superior caval vein and the inferior caval vein are connected to the pulmonary circulation through separate connections that are either direct connections or tubular pathways. A fenestration of a Fontan is defined as a communication that is created to allow flow of blood between the systemic and pulmonary venous chambers.
Fontan, TCPC, External conduit, Nonfenestrated  The external conduit Fontan is a TCPC type of Fontan operation created with anastomosis of SVC to the branch pulmonary artery a conduit outside of the heart to connect the infradiaphragmatic systemic venous return to the pulmonary artery. ?The Fontan? is defined as an operation or intervention that results in caval flow from both the upper and lower body draining to the pulmonary circulation in a patient with a functionally univentricular heart. A ?TCPC? is a Fontan where both the superior caval vein and the inferior caval vein are connected to the pulmonary circulation through separate connections that are either direct connections or tubular pathways. A fenestration of a Fontan is defined as a communication that is created to allow flow of blood between the systemic and pulmonary venous chambers.
Fontan, TCPC, Intra/extracardiac conduit, Fenestrated  The TCPC with Intra/extracardiac conduit is a TCPC type of Fontan operation created with a tube where the tube is attached to the inferior caval vein inside of the heart, and then the tube passes outside of the heart and is attached to the pulmonary artery outside of the heart.?The Fontan? is defined as an operation or intervention that results in caval flow from both the upper and lower body draining to the pulmonary circulation in a patient with a functionally univentricular heart. A ?TCPC? is a Fontan where both the superior caval vein and the inferior caval vein are connected to the pulmonary circulation through separate connections that are either direct connections or tubular pathways. A fenestration of a Fontan is defined as a communication that is created to allow flow of blood between the systemic and pulmonary venous chambers.
Fontan, TCPC, Intra/extracardiac conduit, Nonfenestrated  The TCPC with Intra/extracardiac conduit is a TCPC type of Fontan operation created with a tube where the tube is attached to the inferior caval vein inside of the heart, and then the tube passes outside of the heart and is attached to the pulmonary artery outside of the heart. ?The Fontan? is defined as an operation or intervention that results in caval flow from both the upper and lower body draining to the pulmonary circulation in a patient with a functionally univentricular heart. A ?TCPC? is a Fontan where both the superior caval vein and the inferior caval vein are connected to the pulmonary circulation through separate connections that are either direct connections or tubular pathways. A fenestration of a Fontan is defined as a communication that is created to allow flow of blood between the systemic and pulmonary venous chambers.
Fontan revision or conversion (Re-do Fontan)  ?Fontan revision or conversion (Re-do Fontan)? is defined as an operation where a previously created Fontan circuit is either modified or taken down and changed into a different type of Fontan. ?The Fontan? is defined as an operation or intervention that results in caval flow from both the upper and lower body draining to the pulmonary circulation in a patient with a functionally univentricular heart. A ?TCPC? is a Fontan where both the superior caval vein and the inferior caval vein are connected to the pulmonary circulation through separate connections that are either direct connections or tubular pathways.
Fontan, Other  Other Fontan procedure not specified in procedure codes. May include takedown of a Fontan procedure. ?The Fontan? is defined as an operation or intervention that results in caval flow from both the upper and lower body draining to the pulmonary circulation in a patient with a functionally univentricular heart.
Fontan + Atrioventricular valvuloplasty  ?Fontan + Atrioventricular valvuloplasty? is defined as an operation to repair the systemic atrioventricular valve combined with a Fontan operation. Please also code the type of Fontan operation performed as the second procedure of this operation. ?The Fontan? is defined as an operation or intervention that results in caval flow from both the upper and lower body draining to the pulmonary circulation in a patient with a functionally univentricular heart.
Ventricular septation  Creation of a prosthetic ventricular septum. Surgical procedure used to septate univentricular hearts with two atrioventricular valves. Additional procedures, such as resection of subpulmonic stenosis, should be listed separately.
Congenitally corrected TGA repair, Atrial switch and ASO (double switch)  Repair of congenitally corrected TGA by concomitant atrial switch (Mustard or Senning) and arterial switch operation. VSD closure is usually performed as well, this should be coded separately.
Congenitally corrected TGA repair, Atrial switch and Rastelli  Repair of congenitally corrected TGA by concomitant atrial switch (Mustard or Senning) and VSD closure to the aortic valve with placement of an RV-to-PA conduit.
Congenitally corrected TGA  Repair of congenitally corrected TGA by VSD closure repair, VSD closure only.
Congenitally corrected TGA repair, VSD closure and LV to PA conduit  Repair of congenitally corrected TGA by VSD closure and placement of an LV-to-PA conduit.
Congenitally corrected TGA repair, Other  Any procedures for correction of CCTGA not otherwise specified in other listed procedure codes.
Arterial switch operation (ASO)  Arterial switch operation is used for repair of transposition of the great arteries (TGA). The pulmonary artery and aorta are transected and translocated so that the pulmonary artery arises from the right ventricle and the aorta from the left ventricle. Coronary artery transfer is also accomplished.
Arterial switch operation (ASO) and VSD repair  Arterial switch operation is used for repair of transposition of the great arteries (TGA). The pulmonary artery and aorta are transected and translocated so that the pulmonary artery arises from the right ventricle and the aorta from the left ventricle. Coronary artery transfer is also accomplished. The VSD is closed, usually with a patch.
Arterial switch procedure + Aortic arch repair  Concomitant arterial switch operation and repair of the aortic arch in patients with transposition of the great arteries with intact ventricular septum and associated coarctation of the aorta or interrupted aortic arch.
Arterial switch procedure and VSD repair + Aortic arch repair  Concomitant arterial switch operation with VSD closure and repair of aortic arch in patients with transposition of the great arteries with VSD and associated coarctation of the aorta or interrupted aortic arch.
Senning  Atrial baffle procedure for rerouting of venous flow in TGA resulting in a ?physiological repair?. The caval flow is directed behind the baffle to the mitral valve, left ventricle and pulmonary artery while the pulmonary venous flow is directed in front of the baffle to the tricuspid valve, right ventricle, and aorta. The Senning procedure uses atrial wall to construct the baffle.
Mustard  Atrial baffle procedure for rerouting of venous flow in TGA resulting in a ?physiological repair?. The caval flow is directed behind the baffle to the mitral valve, left ventricle and pulmonary artery while pulmonary venous flow is directed in front of the baffle to the tricuspid valve, right ventricle, and aorta. The Mustard procedure uses patch material to construct the baffle.
Atrial baffle procedure, Mustard or Senning revision  Revision of a previous atrial baffle procedure (either Mustard or Senning), for any reason (e.g., obstruction, baffle leak).
Rastelli  Most often used for patients with TGA-VSD and significant LVOTO, the Rastelli operation consists of an LV-to-aorta intraventricular baffle closure of the VSD and placement of an RV-to-PA conduit.
REV  The Lecompte (REV) intraventricular repair is designed for patients with abnormalities of ventriculoarterial connection in whom a standard intraventricular tunnel repair cannot be performed. It is also suitable for patients in whom an arterial switch procedure with tunneling of the VSD to the pulmonary artery cannot be performed because of pulmonary (left ventricular outflow tract) stenosis. A right ventriculotomy incision is made. The infundibular (conal) septum, located between the two semilunar valves, is aggressively resected if its presence interferes with the construction of a tunnel from the VSD to the aorta. The VSD is then tunneled to the aorta. The decision to perform or not to perform the Lecompte maneuver should be made at the beginning of the operation. If the Lecompte maneuver is not performed the pulmonary artery is translocated to the right ventricular outflow tract on the side of the aorta that provides the shortest route. (When the decision to perform the Lecompte maneuver has been made, the great vessels are transected and this maneuver is performed at the beginning of the operation.) The pulmonary artery orifice is then closed. The aorta, if it had been transected during the performance of the Lecompte maneuver, is then reconstructed. A vertical incision is made on the anterior aspect of the main pulmonary artery. The posterior margin of the pulmonary artery is sutured to the superior aspect of the vertical right ventriculotomy incision. A generous patch of autologous pericardium is used to close the inferior portion of the right ventriculotomy and the anterior portion of the pulmonary artery. A monocusp pericardial valve is inserted extemporaneously.
Aortic root translocation over left ventricle (Including Nikaidoh procedure) .;
TGA, Other procedures (Kawashima, LV-PA conduit, other) .;
DORV, Intraventricular tunnel repair  Repair of DORV using a tunnel closure of the VSD to the aortic valve. This also includes the posterior straight tunnel repair of Kawashima.
DOLV repair  Because of the morphologic variability of DOLV, there are many approaches to repair, including, intraventricular tunnel repair directing the VSD to the pulmonary valve, the REV procedure, or the Rastelli procedure. In the case of DOLV use this code for tunnel closure to the pulmonary valve. If the REV or Rastelli procedures are performed then use those respective codes.
Coarctation repair, End to end  Repair of coarctation of aorta by excision of the coarctation segment and end-to-end circumferential anastomosis of the aorta.
Coarctation repair, End to end, Extended  Repair of coarctation of the aorta by excision of the coarctation segment and end-to-end anastomosis of the oblique ends of the aorta, creating an extended anastomosis.
Coarctation repair, Subclavian flap  Repair of coarctation of the aorta by ligating, dividing, and opening the subclavian artery, incising the coarctation site, and folding down the subclavian artery onto the incision in the aorta, suturing the subclavian "flap" in place, creating a roof over the area of the previous coarctation.
Coarctation repair, Patch aortoplasty  Repair of coarctation of the aorta by incising the coarctation site with placement of a patch sutured in place longitudinally along the aortotomy edge.
Coarctation repair, Interposition graft  Repair of coarctation of the aorta by resection of the coarctation segment and placement of a prosthetic tubular interposition graft anastomosed circumferentially to the cut ends of the aorta.
Coarctation repair, Other  Any repair of coarctation not specified in procedure codes. This may include, for example, a combination of two approaches for coarctation repair or extra-anatomic bypass graft, etc.
Coarctation repair + VSD repair  Coarctation of aorta repair, any technique, and simultaneous VSD repair, any type VSD, any type repair.
Aortic arch repair  Aortic arch repair, any technique.
Aortic arch repair + VSD repair  Aortic arch repair, any technique, and simultaneous VSD repair, any type VSD, any type repair. This includes repair of IAA with VSD.
Coronary artery fistula ligation  Coronary artery fistula repair using any technique. If additional technique information may be supplied by another procedure code, please list separately (e.g.,bypass graft).
Anomalous origin of coronary artery from pulmonary artery repair  Repair of anomalous origin of the coronary artery (any) from the pulmonary artery, by any technique (ligation, translocation with aortic implantation, Takeuchi operation, or bypass graft). If additional technique information may be supplied by another procedure code, please list separately (for example, bypass graft).
Coronary artery bypass  Coronary artery bypass graft procedure, any technique (with or without CPB, venous or arterial graft, one or more grafts, etc.), for any coronary artery pathology (coronary arterial fistula, aneurysm, coronary bridging, atresia of left main, acquired coronary artery disease, etc.).
Anomalous aortic origin of coronary artery from aorta (AAOCA) repair .;
Coronary artery procedure, Other  Any coronary artery procedure not specifically listed.
Interrupted aortic arch repair  Repair of interrupted aortic arch (any type) by any technique (direct anastomosis, prosthetic graft, etc.). Does not include repair of IAA-VSD.
PDA closure, Surgical  Closure of a PDA by any surgical technique (ligation, division, clip) using any approach (i.e., thoracotomy, thoracoscopic, etc.).
PDA closure, Device  Closure of a PDA by device using transcatheter techniques.
Vascular ring repair  Repair of vascular ring (any type, except pulmonary artery sling) by any technique.
Aortopexy  Surgical fixation of the aorta to another structure (usually the posterior aspect of the sternum) to relieve compression on another vessel or structure (e.g., trachea).
Pulmonary artery sling repair  Pulmonary artery sling repair by any technique.
Aortic aneurysm repair Aortic aneurysm repair by any technique.
Aortic dissection repair  Aortic dissection repair by any technique.
Lung biopsy  Lung biopsy, any technique.
Transplant, lung(s)  Lung or lobe transplantation of any type.
Lung procedure, Other  Included in this procedure code would be any lung procedure other than transplant, such as, but not limited to: pneumonectomy (left or right), lobectomy (any lobe), bilobectomy (two lobes), segmental lung resection (any segment), or wedge resection.
Tracheal procedure  Any tracheal procedure, including but not limited to relief of tracheal stenosis (any means including pericardial graft, autograft insertion, homograft insertion, resection with reanastomosis, rib cartilage insertion, or slide tracheoplasty). Tracheal stent placement or balloon dilation should be coded separately.
Muscle flap, Trunk (i.e. intercostal, pectus, or serratus muscle)  A trunk muscle flap (intercostal, pectus, or serratus muscle) is rotated to buttress or augment a suture line, anastomosis or fill the pleural space.
Muscle flap, Trunk (i.e.latissimus dorsi)  A trunk muscle flap (latissimus dorsi) is rotated to buttress or augment a suture line, anastomosis or fill the pleural space.
Removal, Sternal wire  Excision of wire used to approximate sternum, previous sternotomy.
Rib excision, Complete  Complete excision of rib(s).
Rib excision, Partial  Partial excision of rib(s).
Sternal fracture - open treatment  Repair of a sternal fracture with sutures, wires, plates or bars.
Sternal resection, Radical resection of sternum  Involves removal of the sternum with complex reconstructive requirements for either a tumor or severe sternal infection.
Sternal resection, Radical resection of sternum with mediastinal lymphadenectomy  Involves resection of the sternum and mediastinal lymph node dissection.
Tumor of chest wall - Excision including ribs  Excision of ribs and attached muscles for a benign or malignant tumor of the chest wall. When three or less ribs are taken or if the defect is covered by the scapula, reconstruction may not be necessary.
Tumor of chest wall - Excision including ribs, With reconstruction  Resection of the chest wall tumor with reconstruction of the defect, usually with plastic mesh (marlex, prolene), methylmethracralate/mesh sandwich or a muscle flap.
Tumor of soft tissue of thorax - Excision of deep subfascial or intramuscular tumor  Excision of a deep chest wall tumor that involves the muscles but not the ribs. These would usually be benign tumors such as a fibroma or a deep lipoma.
Tumor of soft tissue of thorax - Excision of subcutaneous tumor  Excision of tumor in the skin/fat of the chest wall-typically a lipoma.
Tumor of soft tissue of thorax - Radical resection  En-bloc, radical excision of a cancer of the chest wall muscles, involving the skin, fat and muscles. Typically it would be a desmoid tumor or a sarcoma malignant fibrous histiocytoma, rhabdomyosarcoma.
Hyoid myotomy and suspension  Typically done as a suprahyoid laryngeal release to reduce tension on a cervical tracheal resection anastomosis. The hyoid bone is cut laterally on both sides to allow it to drop down and thus lower the larynx and trachea.
Muscle flap, Neck  A neck muscle flap is rotated to buttress or augment a suture line, anastomosis or fill a space. Commonly used neck muscles are strap muscles, sternocleidomastoid muscle, levator scapulae.
Procedure on neck  Unlisted procedure of the neck.
Tumor of soft tissue of neck - Excision of deep subfascial or intramuscular tumor  Excision of a tumor that involves the muscles of the neck. These would usually be benign tumors such as a fibroma or a deep lipoma.
Tumor of soft tissue of neck - Excision of subcutaneous tumor  Excision of a tumor in the skin/fat of the neck-typically a lipoma.
Tumor of soft tissue of neck - Radical resection  A surgical procedure in which the fibrofatty contents of the neck are removed for the treatment of cervical lymphatic metastases. Neck dissection is most commonly used in the management of cancers of the upper aerodigestive tract. It is also used for malignancies of the skin of the head and neck area, the thyroid, and the salivary glands.
Pectus bar removal  Removal of a previously implanted chest wall bar.
Pectus bar repositioning  Repositioning of a previously implanted chest wall bar.
Pectus repair, Minimally invasive repair (Nuss) With thoracoscopy  Placement of a Nuss transverse chest wall bar to push the sternum forward to repair a pectus deformity, with thoracoscopy.
Pectus repair, Minimally invasive repair (Nuss), Without thoracoscopy  Placement of a Nuss transverse chest wall bar to push the sternum forward to repair a pectus deformity, without thoracoscopy.
Pectus repair, Open repair  Resection of several costal cartilages, a partial osteotomy of the sternum, and often placement of a temporary bar for stabilization of pectus chest wall deformity.
Division of scalenus anticus, With resection of a cervical rib  Repair of Thoracic Outlet Syndrome variant where the scalenus anticus muscle or a band from it impinges on the brachial plexus along with resection of the abnormal cervical rib.
Division of scalenus anticus, Without resection of a cervical rib  Repair of Thoracic Outlet Syndrome variant where the scalenus anticus muscle or a band from it impinges on the brachial plexus along without resection of the abnormal cervical rib.
Rib excision, Excision of cervical rib  Removal of the first rib or a cervical rib for treatment of Thoracic Outlet Syndrome.
Rib excision, Excision of cervical rib, With sympathectomy  Removal of the first rib or a cervical rib and sympathectomy for treatment of Thoracic Outlet Syndrome.
Rib excision, Excision of first rib  Removal of the first rib.
Rib excision, Excision of first rib, With sympathectomy  Removal of the first rib and sympathectomy.
Procedure on thorax  Unlisted procedure on thorax.
Pacemaker implantation, Permanent  Implantation of a permanent pacemaker of any type (e.g., single-chamber, dual-chamber, atrial antitachycardia), with any lead configuration or type (atrial, ventricular, atrial and ventricular, transvenous, epicardial, transmural), by any technique (sternotomy, thoracotomy etc.).
Pacemaker procedure  Any revision to a previously placed pacemaker system including revisions to leads, generators, pacemaker pockets. This may include explantation of pacemakers or leads as well.
Explantation of pacing system  Removal of pacemaker generator and wires.
ICD (AICD) implantation  Implantation of an (automatic) implantable cardioverter defibrillator system.
ICD (AICD) ([automatic] implantable cardioverter defibrillator) procedure  Any revision to a previously placed AICD including revisions to leads, pads, generators, pockets. This may include explantation procedures as well.
Arrhythmia surgery - atrial, Surgical Ablation  Surgical ablation (any type) of any atrial arrhythmia.
Arrhythmia surgery - ventricular, Surgical Ablation  Surgical ablation (any type) of any ventricular arrhythmia.
Cardiovascular  Invasive diagnostic procedure involving the heart and catheterization procedure, Diagnostic great vessels.
Cardiovascular catheterization procedure, Diagnostic, Angiographic data obtained  Invasive diagnostic procedure involving the heart and great vessels using angiography.
Cardiovascular catheterization procedure, Diagnostic, Electrophysiology alteration .;
Cardiovascular catheterization procedure, Diagnostic, Hemodynamic alteration  Invasive diagnostic procedure involving pressure or flow alteration in the cardiovascular system.
Cardiovascular catheterization procedure, Diagnostic, Hemodynamic data obtained  Invasive diagnostic procedure involving pressure and flow assessment of the heart and great vessels.
Cardiovascular catheterization procedure, Diagnostic, Transluminal test occlusion .;
Cardiovascular catheterization procedure, Therapeutic  Invasive therapeutic procedure involving the heart and great vessels.
Cardiovascular catheterization procedure, Therapeutic, Adjunctive therapy .;
Cardiovascular catheterization procedure, Therapeutic, Balloon dilation  Invasive therapeutic procedure involving balloon dilatation of a cardiovascular structure.
Cardiovascular catheterization procedure, Therapeutic, Balloon valvotomy  Invasive therapeutic procedure involving balloon dilatation of a valve.
Cardiovascular catheterization procedure, Therapeutic, Coil implantation  Invasive therapeutic procedure involving implantation of a coil.
Cardiovascular catheterization procedure, Therapeutic, Device implantation  Invasive therapeutic procedure involving implantation of a device.
Cardiovascular catheterization procedure, Therapeutic, Device implantation attempted  Invasive therapeutic procedure involving attempted but unsuccessful implantation of a device.
Cardiovascular catheterization procedure, Therapeutic, Electrophysiological ablation  Invasive therapeutic procedure involving Catheter based catheterization procedure,  creation of lesions in the heart with radiofrequency energy, cryotherapy , or ultrasound energy to cure or control arrhythmias.
Cardiovascular catheterization procedure, Therapeutic, Intravascular foreign body removal  Invasive therapeutic procedure involving removal of an intravascular foreign body.
Cardiovascular catheterization procedure, Therapeutic, Perforation (establishing interchamber and/or intervessel communication)  Invasive therapeutic procedure establishing interchamber and/or intervessel communication.
Cardiovascular catheterization procedure, Therapeutic, Septostomy  Invasive therapeutic procedure establishing an intracardiac septal communication.
Cardiovascular catheterization procedure, Therapeutic, Stent insertion  Invasive therapeutic procedure involving implantation of a stent.
Cardiovascular catheterization procedure, Therapeutic, Stent re-dilation  Invasive therapeutic procedure involving dilatation of a previously implanted stent.
Cardiovascular catheterization procedure, Therapeutic, Transcatheter Fontan completion .;
Cardiovascular catheterization procedure, Therapeutic, Transcatheter implantation of valve  Invasive therapeutic procedure involving deployment/implantation of a valve.
Shunt, Systemic to pulmonary, Modified Blalock-Taussig Shunt (MBTS)  Placement of a tube graft from a branch of the aortic arch to the pulmonary artery with or without bypass, from any approach (thoracotomy, sternotomy).
Shunt, Systemic to pulmonary, Central (shunt from aorta)  A direct anastomosis or placement of a tube graft from the aorta to the pulmonary artery with or without bypass, from any approach (thoracotomy, sternotomy).
Shunt, Systemic to pulmonary, Central (shunt from aorta), Central shunt with an end-to-side connection between the transected main pulmonary artery and the side of the ascending aorta (i.e. Mee shunt)  Creation of a central shunt with an end-to-side connection between the transected main pulmonary artery and the side of the ascending aorta.
Shunt, Systemic to pulmonary, Other  Placement of any other systemic-to-pulmonary artery shunt, with or without bypass, from any approach (thoracotomy, sternotomy) that is not otherwise coded. Includes classic Blalock-Taussig systemic-to-pulmonary artery shunt.
Shunt, Ligation and takedown  Takedown of any shunt.
Shunt, Reoperation  Revision or replacement of a previously created shunt.
PA banding (PAB)  Placement of a pulmonary artery band, any type.
PA debanding  Debanding of pulmonary artery. Please list separately any pulmonary artery reconstruction required.
Damus-Kaye-Stansel procedure (DKS) (creation of AP anastomosis without arch reconstruction)  In the Damus-Kaye-Stansel procedure the proximal transected main pulmonary artery is connected by varying techniques to the aorta.
Bidirectional cavopulmonary anastomosis (BDCPA)(bidirectional Glenn)  Superior vena cava to pulmonary artery anastomosis allowing flow to both pulmonary arteries with an end-to-side superior vena-to-pulmonary artery anastomosis.
Glenn (unidirectional cavopulmonary anastomosis)(unidirectional Glenn)  Superior vena cava to ipsilateral pulmonary artery anastomosis (i.e., LSVC to LPA, RSVC to RPA).
Bilateral bidirectional cavopulmonary anastomosis(BBDCPA) (bilateral bidirectional Glenn)  Bilateral superior vena cava-to-pulmonary artery anastomoses (requires bilateral SVCs).
HemiFontan  A HemiFontan is an operation that includes a bidirectional superior vena cava (SVC)-to-pulmonary artery anastomosis and the connection of this ?SVC-pulmonary artery amalgamation? to the atrium, with a ?dam? between this ?SVC-pulmonary artery amalgamation? and the atrium. This operation can be accomplished with a variety of operative strategies including the following two techniques and other techniques that combine elements of both of these approaches: (1) Augmenting both branch pulmonary arteries with a patch and suturing the augmented branch pulmonary arteries to an incision in the medial aspect of the superior vena cava. (With this approach, the pulmonary artery patch forms a roof over the SVC-to-pulmonary artery anastomosis and also forms a ?dam? between the SVC-pulmonary artery amalgamation and the right atrium.) (2) Anastomosing both ends of the divided SVC to incisions in the top and bottom of the right pulmonary artery, and using a separate patch to close junction of the SVC and the right atrium.
Superior cavopulmonary anastomosis(es) (Glenn or HemiFontan) + Atrioventricular valvuloplasty .
Superior Cavopulmonary anastomosis(es) + PA reconstruction .
Hepatic vein to azygous vein connection, Direct .
Hepatic vein to azygous vein connection, Interposition graft .
Kawashima operation (superior cavopulmonary connection in setting of interrupted IVC with azygous continuation) .
Palliation, Other  Any other palliative procedure not specifically listed.
ECMO cannulation  Insertion of cannulas for extracorporeal membrane oxygenation.
ECMO decannulation  Removal of cannulas for extracorporeal membrane oxygenation.
ECMO procedure  Any ECMO procedure (cannulation, decannulation, etc.).
Intraaortic balloon pump (IABP) insertion  Insertion of intraaortic balloon pump by any technique.
Right/left heart assist device procedure  Any right, left, or biventricular assist device procedure (placement, removal etc.).
VAD explantation  Removal of ventricular assist device.
VAD implantation  Insertion of a ventricular assist device.
VAD change out  Removal of previously inserted ventricular assist device and insertion of a new device.
Echocardiography procedure, Sedated transesophageal echocardiogram  Procedural sedation for echocardiogram.
Echocardiography procedure, Sedated transthoracic echocardiogram  Procedural sedation for echocardiogram, transthoracic.
Non-cardiovascular, Non-thoracic procedure on cardiac patient with cardiac anesthesia  Anesthesia provided by cardiac anesthesiologist for patient with congenital heart disease undergoing a non-cardiovascular, non-thoracic procedure.
Radiology procedure on cardiac patient, Cardiac Computerized Axial Tomography (CT Scan)  A patient with congenital heart disease undergoing cardiac CT scan.
Radiology procedure on cardiac patient, Cardiac Magnetic Resonance Imaging (MRI)  A patient with congenital heart disease undergoing cardiac MRI.
Radiology procedure on cardiac patient, Diagnostic radiology  A patient with congenital heart disease undergoing a diagnostic radiology procedure.
Radiology procedure on cardiac patient, Non-Cardiac Computerized Tomography (CT) on cardiac patient  A patient with congenital heart disease undergoing a non-cardiac CT scan.
Radiology procedure on cardiac patient, Non-cardiac Magnetic Resonance Imaging (MRI) on cardiac patient  A patient with congenital heart disease undergoing non-cardiac MRI.
Radiology procedure on cardiac patient, Therapeutic radiology  A patient with congenital heart disease undergoing a therapeutic radiology procedure.
Aneurysm, Ventricular, Right, Repair  Repair of right ventricular aneurysm, any technique.
Aneurysm, Ventricular, Left, Repair  Repair of left ventricular aneurysm, any technique.
Aneurysm, Pulmonary artery, Repair  Repair of pulmonary artery aneurysm, any technique.
Cardiac tumor resection  Resection of cardiac tumor, any type.
Pulmonary AV fistula repair/occlusion  Repair or occlusion of a pulmonary arteriovenous fistula.
Ligation, Pulmonary artery  Ligation or division of the pulmonary artery. Most often performed as a secondary procedure.
Pulmonary embolectomy, Acute pulmonary embolus  Acute pulmonary embolism (clot) removal, through catheter or surgery.
Pulmonary embolectomy, Chronic pulmonary embolus  Chronic pulmonary embolism (clot) removal, through catheter or surgery.
Pleural drainage procedure  Pleural drainage procedure via thoracocentesis, tube thoracostomy, or open surgical drainage.
Pleural procedure, Other  Other pleural procedures not specifically listed
Ligation, Thoracic duct  Ligation of the thoracic duct, most commonly for persistent chylothorax.
Decortication  Decortication of the lung by any technique.
Esophageal procedure  Any procedure performed on the esophagus.
Mediastinal procedure  Any non-cardiovascular mediastinal procedure not otherwise listed.
Bronchoscopy  Bronchoscopy, rigid or flexible, for diagnostic, biopsy, or treatment purposes (laser, stent, dilation, lavage).
Diaphragm plication  Plication of the diaphragm
Diaphragm procedure, Other  Any diaphragm procedure not specifically listed.
VATS (video-assisted thoracoscopic surgery)  Video-assisted thoracoscopic surgery utilized
Minimally invasive procedure  Any procedure using minimally invasive technique
Bypass for noncardiac lesion  Use of cardiopulmonary bypass for noncardiac lesion, this code may be used in addition to the specific procedure code if one is available (e.g., tracheal procedures may be done using CPB - the tracheal procedure should be the primary procedure and use of cardiopulmonary bypass for noncardiac lesion should be listed additionally).
Delayed sternal closure  Sternal closure effected after patient has left operating room with sternum open, either because of swelling or electively after complex heart procedures. This procedure should be operative type No CPB Cardiovascular.
Mediastinal exploration  Mediastinal exploration, most often for postoperative control of bleeding or tamponade, but may be exploration to assess mediastinal mass, etc.
Sternotomy wound drainage  Drainage of the sternotomy wound.
Intravascular stent removal  Removal of a previously placed intravascular stent.
Thoracotomy, Other  Any procedure performed through a thoracotomy incision not otherwise listed.
Cardiotomy, Other  Any procedure involving an incision in the heart that is not otherwise listed.
Cardiac procedure, Other  Any cardiac procedure, bypass or non-bypass, that is not otherwise listed.
Thoracic and/or mediastinal procedure, Other  Any thoracic and/or mediastinal procedure not otherwise listed.
Peripheral vascular procedure, Other  Any peripheral vascular procedure
Miscellaneous procedure, Other  Any miscellaneous procedure not otherwise listed.
Organ procurement  Procurement of an organ for transplant (most likely, heart, lungs, or heart and lungs).
Other procedure  Any procedure on any organ system not otherwise listed.
Operation canceled before skin incision  Surgical procedure canceled after patient enters the operating room but prior to skin incision.
Operation aborted after skin incision  Surgical procedure canceled after skin incision made.