© Copyright 2025 American Medical Association. All rights reserved.
An aortoplasty using a gusset is a surgical procedure specifically designed to address supravalvular stenosis, a congenital condition characterized by the narrowing of the ascending aorta just above the sinuses of Valsalva. This condition leads to an obstruction in the left ventricular outflow tract, which can significantly impact cardiac function. The procedure involves a series of carefully orchestrated steps to ensure the successful widening of the affected area. The surgical approach typically begins with a median sternotomy, which provides access to the heart and aorta. Following this, cardiopulmonary bypass is initiated to maintain circulation and oxygenation during the surgery. A distinctive inverted Y-shaped incision is made in the ascending aorta, extending across the supravalvular ring and into the noncoronary and right sinuses of Valsalva, allowing for direct access to the stenotic region. To effectively enlarge the narrowed area, a synthetic patch, referred to as a gusset, is placed over the incision. This patch is sutured securely to the aorta, thereby increasing the diameter of the stenotic region and facilitating improved blood flow. After the patch placement, cardiopulmonary bypass is discontinued, and the chest incisions are closed, marking the completion of the procedure.
© Copyright 2025 Coding Ahead. All rights reserved.
The aortoplasty (gusset) for supravalvular stenosis is indicated for patients presenting with the following conditions:
The procedure for aortoplasty using a gusset involves several critical steps to ensure effective treatment of supravalvular stenosis:
Post-procedure care for patients who have undergone aortoplasty using a gusset typically involves monitoring for any complications related to the surgery, such as bleeding or infection. Patients may require a period of recovery in a hospital setting, where their vital signs and cardiac function can be closely observed. Follow-up appointments will be necessary to assess the success of the procedure and ensure that the aorta is healing properly. Additional imaging studies may be performed to evaluate the effectiveness of the patch and the overall condition of the aorta.
| Short Descr | REPAIR OF AORTIC VALVE | Medium Descr | AORTOPLASTY SUPRAVALVULAR STENOSIS | Long Descr | Aortoplasty (gusset) for supravalvular stenosis | Status Code | Active Code | Global Days | 090 - Major Surgery | 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) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | 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.
| 33141 | Addon Code MPFS Status: Active Code APC C Physician Quality Reporting PUB 100 CPT Assistant Article Transmyocardial laser revascularization, by thoracotomy; performed at the time of other open cardiac procedure(s) (List separately in addition to code for primary procedure) | 33257 | Addon Code MPFS Status: Active Code APC C Illustration for Code Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), limited (eg, modified maze procedure) (List separately in addition to code for primary procedure) | 33259 | Addon Code MPFS Status: Active Code APC C Illustration for Code Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), extensive (eg, maze procedure), with cardiopulmonary bypass (List separately in addition to code for primary procedure) | 33530 | Addon Code MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Reoperation, coronary artery bypass procedure or valve procedure, more than 1 month after original operation (List separately in addition to code for primary procedure) | 34714 | Addon Code MPFS Status: Active Code APC N ASC N1 Open femoral artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by groin incision, unilateral (List separately in addition to code for primary procedure) | 34716 | Addon Code MPFS Status: Active Code APC N ASC N1 Open axillary/subclavian artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by infraclavicular or supraclavicular incision, unilateral (List separately in addition to code for primary procedure) | 34833 | Addon Code Resequenced Code MPFS Status: Active Code APC C CPT Assistant Article Open iliac artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by abdominal or retroperitoneal incision, unilateral (List separately in addition to code for primary procedure) |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician |
|
Date
|
Action
|
Notes
|
|---|---|---|
| Pre-1990 | Added | Code added. |
Get instant expert-level medical coding assistance.