Ask Dr. Z

Can we bill RVOT stent placement (33745) with a Melody Valve for narrowing of the RVOT? "A P4010 stent was mounted on a 24-5 BIB catheter and advanced through the long sheath into the RV outflow tract. The stent was uncovered without difficulty and deployed by inflating the inner and outer balloons to 6 atmospheres, and repeat angiography through the long sheath into the RV demonstrated stable position of the stent across the narrowest dimension. We then proceeded with placement of the Melody valve. On the back table, the 22 mm Melody valve was prepped per protocol with a P3110 stent mounted on the outside of the Melody valve. RVOT pre-stented with Palmaz 4010 stent bare metal stent using 24-5 BIB catheter. Melody valve 22 mm placed using 22 French, 22 mm Ensemble delivery system with a Palmaz 3110 stent mounted over the Melody valve."