Ask Dr. Z

Can code 34716 be reported when performing a TAVR? STS guidance states graft conduit creation is included in TAVR codes, but our surgeons do not agree. No definitive coding guidance exists.

Per the surgeon: "Our primary approach is to surgically place a conduit onto the axillary artery. This is not covered by code 33363. That is covered by code 34716. Not used for just bypass but also for delivery of endovascular prostheses (a.k.a., a TAVR valve)."

OP report example: "Side biter was placed, followed by arteriotomy and placement of an 8 mm graft in an end-to-side fashion. Graft was flushed with heparin and distal clamp placed. This allowed placement of a 6 French sheath into the graft. An AL1 diagnostic catheter and straight TSF guidewire were then used to advance across the stenotic aortic valve and placed into the LV. The LV catheter was then placed. This allowed passage of the 14 French delivery sheath under fluoroscopy into the arch. No BAV was performed due to pre-existing AI. The Edwards S3 23mm TAVR delivery system was advanced over the wire and across the aortic valve."