Ask Dr. Z

Ask Dr. Z Knowledge Base houses over 7,500 coding questions and answers dating back to 2013.

Ask Dr. Z Disclaimer

Please note this question was answered in 2021. The coding advice may or may not be outdated.

VAD Impella Insertion exceeding MUE

Date: Jun 7, 2021

Question:

These insertions were performed on the same DOS. Patient was released from the cath lab and was brought back 5 hours later. See documentation below. How would we code the second insertion, 33990?

"The Impella is seen to have migrated to the arch of the aorta. Despite multiple attempts, we were not able to prolapse the Impella CP across the patient's aortic valve. Our next plan was to use a snare through JR4 guide and use it to snare the tip of the Impella pigtail and push it across the aortic valve. However, we noted that there is spasm in the radial artery and did not resolve with nitroglycerin. Hence, we decided to proceed with Impella removal and insertion of new device."

Sign up for a membership to view the answer to this question.

Need to ask Dr.Z?

Don't see the answer you're looking for in the knowledge base? No problem. You can ask Dr. Z directly!
Ask Dr. Z a question now!