Ask Dr. Z

Patient presented with severe stenosis and regurgitation of bioprosthetic valve (previous TAVR). The patient also has a history of CABG. The bioprosthetic valve was found to be adhered to the ascending aorta and the ascending aorta needed to be replaced from the distal to the sinotubular junction. The bio valve and the native valve were excised, and a new valve was placed. 33405-22 for this portion. The surgeon then had to reimplant the previous coronary bypass grafts into the newly grafted ascending aorta. I am certain we need to go with an unlisted code for the ascending aorta replacement and thinking that we'll utilize 33859 as the comparable code after confirming with the surgeon. Also, adding 33530 for the re-operation. Is there anything additional that you would recommend?