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Impella 5.5 Direct Aortic Implant

Date: Feb 14, 2023

Question:

Patient had an Impella 5.5 with Smart Assist inserted during a CABG. The provider brought an 8mm graft into the field, it was bevelled and sewn end-to-side at the distal ascending aorta to use as a conduit for the direct implantation of the Impella. A small incision was made at the right side of the neck and the 8mm graft was tunnelled out of this incision. The sheath was placed in the graft and using TEE, the wire was advanced to the aortic valve. The Impella 5.5 was brought into the graft and delivered to the aorta through the aortic valve and placed in position, verified by TEE. The provider has coded 33975. I've never seen a direct aortic implant before. Would the conduit he created be an unlisted code? Compared to 34716? Thank you.

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