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Transcatheter aortic valve replacement (TAVR/TAVI) is a minimally invasive procedure designed to replace a diseased aortic valve in patients suffering from symptomatic aortic stenosis. This condition occurs when the aortic valve narrows, restricting blood flow from the heart to the rest of the body, which can lead to serious health complications. TAVR/TAVI serves as an alternative to traditional open-heart surgery for aortic valve replacement, offering a less invasive option that can be performed through various access points, including the open iliac artery approach. The procedure involves the use of advanced catheter-based techniques, allowing for the implantation of a prosthetic valve without the need for extensive surgical intervention. During the procedure, various imaging techniques, such as transthoracic echocardiography, are utilized to assess the aortic valve's size and function, ensuring proper placement of the new valve. The use of multiple catheters and fluoroscopic guidance is critical in navigating the vascular system and accurately positioning the prosthetic valve within the heart. Overall, TAVR/TAVI represents a significant advancement in the treatment of aortic stenosis, providing patients with a viable option to improve their quality of life and reduce the risks associated with more invasive surgical procedures.
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Transcatheter aortic valve replacement (TAVR/TAVI) is indicated for patients who exhibit symptoms of aortic stenosis, which may include shortness of breath, chest pain, or fatigue. The procedure is typically recommended for individuals who are at high risk for complications from traditional open-heart surgery or those who are considered inoperable due to other medical conditions.
The transcatheter aortic valve replacement procedure via the open iliac artery approach involves several critical steps to ensure successful implantation of the prosthetic valve. Initially, pulmonary and radial artery catheters may be inserted for hemodynamic monitoring, providing essential data throughout the procedure. Transthoracic echocardiography is performed to confirm the diameter of the aortic valve, which is crucial for selecting the appropriate size of the prosthetic valve. In some cases, transesophageal echocardiography may be utilized as a separate reportable procedure for more detailed imaging.
After the transcatheter aortic valve replacement procedure, patients are typically monitored closely for any complications. Expected recovery includes observation for signs of bleeding or infection at the vascular access site. Patients may experience some discomfort or pain, which can be managed with appropriate analgesics. Follow-up echocardiography may be performed to assess the function of the newly implanted valve. It is essential for patients to adhere to post-procedure care instructions, including activity restrictions and medication management, to ensure optimal recovery and valve function.
| Short Descr | REPLACE AORTIC VALVE OPEN | Medium Descr | REPLACE AORTIC VALVE OPEN ILIAC ARTERY APPROACH | Long Descr | Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; open iliac artery approach | Status Code | Active Code | Global Days | 000 - Endoscopic or Minor Procedure | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 2 - Co-surgeons permitted and no documentation required if the two- specialty requirement is met. | Team Surgery (66) | 1 - Team surgeons could be paid, though... | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P2F - Major procedure, cardiovascular-Other | MUE | 1 | CCS Clinical Classification | 43 - Heart valve procedures |
This is a primary code that can be used with these additional add-on codes.
| 33367 | Addon Code MPFS Status: Active Code APC C Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; cardiopulmonary bypass support with percutaneous peripheral arterial and venous cannulation (eg, femoral vessels) (List separately in addition to code for primary procedure) | 33368 | Addon Code MPFS Status: Active Code APC C Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; cardiopulmonary bypass support with open peripheral arterial and venous cannulation (eg, femoral, iliac, axillary vessels) (List separately in addition to code for primary procedure) | 33369 | Addon Code MPFS Status: Active Code APC C Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; cardiopulmonary bypass support with central arterial and venous cannulation (eg, aorta, right atrium, pulmonary artery) (List separately in addition to code for primary procedure) | 33370 | Add-on Code MPFS Status: Active Code APC N Transcatheter placement and subsequent removal of cerebral embolic protection device(s), including arterial access, catheterization, imaging, and radiological supervision and interpretation, percutaneous (List separately in addition to code for primary procedure) | 37252 | Addon Code MPFS Status: Active Code APC N ASC N1 Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; initial noncoronary vessel (List separately in addition to code for primary procedure) | 37253 | Addon Code MPFS Status: Active Code APC N ASC N1 Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; each additional noncoronary vessel (List separately in addition to code for primary procedure) | 93568 | Addon Code MPFS Status: Active Code APC N ASC N1 Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for nonselective pulmonary arterial angiography (List separately in addition to code for primary procedure) | 93569 | Add-on Code MPFS Status: Active Code APC N Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (List separately in addition to code for primary procedure) | 93573 | Add-on Code Resequenced Code MPFS Status: Active Code APC N Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (List separately in addition to code for primary procedure) | 93574 | Add-on Code Resequenced Code MPFS Status: Active Code APC N Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac catheterization (List separately in addition to code for primary procedure) | 93575 | Add-on Code Resequenced Code MPFS Status: Active Code APC N Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (MAPCAs) arising off the aorta or its systemic branches, during cardiac catheterization for congenital heart defects, each distinct vessel (List separately in addition to code for primary procedure) | 93662 | Addon Code MPFS Status: Carrier Priced APC N PUB 100 CPT Assistant Article Intracardiac echocardiography during therapeutic/diagnostic intervention, including imaging supervision and interpretation (List separately in addition to code for primary procedure) |
| 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | Q0 | Investigational clinical service provided in a clinical research study that is in an approved clinical research study |
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| 2013-01-01 | Added | Added |
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