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Valvectomy of the tricuspid valve is a surgical procedure that involves the removal of the tricuspid valve, which is situated between the right atrium and the right ventricle of the heart. This procedure is typically performed using cardiopulmonary bypass, a technique that temporarily takes over the function of the heart and lungs during surgery, allowing the surgeon to operate on a still and bloodless field. The tricuspid valve may be excised when it is severely damaged, often due to conditions such as infective endocarditis, which is an infection of the heart valves. In cases where there is a significant risk of re-infection, particularly in patients with a history of intravenous drug use, the valve is removed without replacement. The surgical approach usually involves a median sternotomy, which is an incision made along the sternum to access the heart. Once the heart is exposed, cardiopulmonary bypass is initiated, and cardioplegia, a method to induce temporary cardiac arrest, is performed to facilitate the procedure. The surgeon then makes an incision in the right atrium to access and excise the tricuspid valve, including its leaflets, chordae tendineae, and associated papillary muscles. After the valve is removed, the incision in the heart is closed, and the patient is gradually weaned off the cardiopulmonary bypass. Post-operative care may include the placement of chest tubes to manage any fluid accumulation, followed by closure of the chest cavity.
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The procedure of tricuspid valve valvectomy is indicated in specific clinical scenarios where the tricuspid valve is severely compromised. The following conditions warrant this surgical intervention:
The procedure for tricuspid valve valvectomy involves several critical steps to ensure successful removal of the valve while maintaining patient safety and stability.
Post-procedure care following a tricuspid valve valvectomy includes monitoring the patient for any complications that may arise from the surgery. Patients are typically observed in a recovery area where vital signs are closely monitored. The placement of chest tubes is essential for draining any excess fluid or blood that may accumulate in the chest cavity. Recovery may involve pain management and gradual mobilization to promote healing. The healthcare team will also assess the patient's cardiac function and overall recovery progress before discharge. Follow-up appointments are crucial to monitor the patient's condition and ensure proper healing.
| Short Descr | REVISION OF TRICUSPID VALVE | Medium Descr | VALVECTOMY TRICUSPID VALVE W/CARDIOPULMONARY BYP | Long Descr | Valvectomy, tricuspid valve, with cardiopulmonary bypass | 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). | 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.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery |
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| Pre-1990 | Added | Code added. |
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