Ask Dr. Z

Plan was to provide perventricular access for device closure of muscular ventricular septal defect by cardiac catheterization team. Pericardium was opened by CTS. An 18-gauge needle advanced through pursestring suture into RV. Wire from a 9 Fr sheath advanced through the needle & under echo guidance across VSD into LV. Wire was in LV, needle was removed & 9 Fr sheath was advanced over the wire across the VSD into LV. Wire & dilator were removed & sheath flushed. Tip of the loader was then cut off once the device 14 mm Amplatzer muscular VSD was fully pulled into the loader. The loader was advanced into the 9 Fr sheath. VSD device advanced through the 9 Fr sheath into VSD under TEE guidance. Device was manipulated & placed straddling ventricular septum under TEE guidance & release the device which was done by unscrewing it from the delivery cable. At this point the device appeared to be quite stable and the sheath was removed & pursestring suture was secured.

Would you code 33681-52 since no CPB used or unlisted code 33999 vs 93799?