Ask Dr. Z

"We have a TAVR performed via transfemoral approach that was completed, but after the delivery system was removed, the soft wire was put back in when we noticed the valve had embolized into the ventricle. This was not causing significant ectopy. We then placed a pigtail in to keep the valve from obstructing while the surgical team was preparing for open surgery. Patient's vitals and blood pressures remained good throughout the case. The large E sheath will be removed, and the artery will be sutured using the preclosed devices. The 5 French arterial sheath and an 8 French venous sheath were left in place. They will be removed at the end of the surgical case. Please see Dr. K note for full details." In this case would you report code 33361, as the TAVR was fully completed and then a complication was noted, or would you report code 33361 with a modifier (-52 or -53) since there was a complication?