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LA-LV fistula suture repair with AVR

Date: Apr 21, 2021

Question:

Can LA-LV fistula suture repair be reported when done in conjunction with AVR? If so, what code could be used for that procedure? I've looked at 33305 and 33315, but neither seem quite right because those codes are associated with trauma; also considered unlisted code but with the fistula repair having been completed during the AVR and no significant extra time or effort documented I'm not sure it qualifies for an additional CPT and payment.

"The old aortotomy site was reopened. This provided good exposure with findings as described. The valve was removed. All pledgets were removed and everything sent for cultures. The annulus was debrided further. Using a right angle clamp, we were able to find the fistula between the ventricle and the atrium. This was closed with a pericardial pledgeted 4-0 Prolene suture."

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