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Recurrent Coarc from Post-Surgical Cord Lesion- 33897 or 37246?

Date: Aug 15, 2022

Question:

Would this be considered congenital 33897, or would the scar tissue/cord lesion mean this was 37246?

"Patient was admitted for a cardiac cath for evaluation of CHD consisting of recurrent coarctation of the aorta. He was diagnosed with a discrete juxtaductal coarctation and ascending aorta hypoplasia. He underwent a surgical coarctation repair via extended end-to-end anastomosis. At recent cardiology visit, the velocity across the descending aorta had a large increase from his post op echo. He presents for cardiac cath balloon angioplasty of recurrent coarctation of the aorta. A pigtail catheter was inserted into the descending aorta. Angio and pressure gradients were obtained. We advanced a balloon over across the cord lesion. An inflation was performed by hand. There was a discrete post-surgical coarctation of the aorta just distal to the lower segment artery. Angiography demonstrated much improved angiographic appearance of the cord lesion. Patient had successful balloon angioplasty of recurrent coarctation of the aorta. An angiogram suggests that the scar tissue has been liberated." 

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