3 2 1 CODE IT Michelle A Green

3 -2 -1 CODE IT! Michelle A. Green, 3 -2 -1 Code IT!, Seventh Edition. © 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Chapter 13 CPT Surgery III © 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Chapter Outline • Cardiovascular System Subsection • Hemic and Lymphatic Systems Subsection © 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Chapter Objectives At the conclusion of this chapter, the student should be able to: • Define key terms related to the Cardiovascular System and Hemic and Lymphatic Systems subsections of CPT Surgery. • Assign codes from the Cardiovascular System subsection of CPT Surgery. • Assign codes from the Hemic and Lymphatic Systems subsection of CPT Surgery. © 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Introduction • Cardiovascular System subsection • Classify Heart and pericardium, valves, and peripheral vascular vessels procedures • Hemic and Lymphatic Systems subsection • Classify spleen, lymph nodes, an lymphatic channels procedures • CPT guidelines • Located at beginning of Surgery section • Unique coding instructions • Located below headings or codes © 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Cardiovascular System Subsection • Headings include: • Heart and Pericardium • Arteries and Veins • Codes are arranged anatomically and then according to procedure performed • Cardiovascular System notes • Parenthetical notes advise review of other codes and sections to locate additional codes associated with certain cardiovascular system procedures © 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Selective Vascular Catheterization • Knowledge about flow of blood is crucial • Selective catheterization • Insertion of catheter into arterial branches for the purpose of performing diagnostic or therapeutic procedures • Usually performed under fluoroscopic guidance • Code reported includes introduction of catheter into the punctured vessel and guidance through all lesser- (or first-) order vessels • Nonselective catheterization • Introducing catheter directly into vessel without further advancement (past punctured vessel) • Introduction of catheter into any portion of aorta or vena cava from any approach © 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Guidewire and Catheter Insertion © 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Artery Vascular Families: First-, second-, third-, and fourth-order vessels © 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Heart and Pericardium Heading • • • Pericardium Cardiac Tumor Transmyocardial Revascularization (TMR) Pacemaker or Implantable Defibrillator Electrophysiologic Operative Procedures Patient-Activated Event Recorder Heart (Including Valves) and Great Vessels Cardiac Valves Other Valvular Procedures Coronary Artery Anomalies Endoscopy • • • Coronary Artery Bypass Graft (CABG) Procedures Coronary Endarterectomy Single Ventricle and Other Complex Cardiac Anomalies Congenital Heart Defects Thoracic Aortic Aneurysm Endovascular Repair of Descending Thoracic Aorta Pulmonary Artery Heart/Lung Transplantation Extracorporeal Membrane Oxygenation or Extracorporeal Life Support Services Cardiac Assist © 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Implantable Artificial Pacemaker © 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Implantable Defibrillator © 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Mitral Valve Replacement © 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Coronary Artery Bypass Graft (CABG) © 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Aortic Aneurysm Repair Aortic aneurysm Graft repair of aneurysm © 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Arteries and Veins Heading • • • • Embolectomy/Thrombectomy Venous Reconstruction Repair of Aneurysms Repair Arteriovenous Fistula Repair Blood Vessel Other Than for Fistula, With or Without Patch Angioplasty Thromboendarterectomy Angioscopy Bypass Graft Composite Grafts Adjuvant Techniques Arterial Transposition Excision, Exploration, Repair, Revision Vascular Injection Procedures Arterial • Intraosseous • Hemodialysis Access, Intervascular Cannulation for Extracorporeal Circulation, or Shunt Insertion • Dialysis Circuit • Portal Decompression Procedures • Transcatheter Procedures • Endovascular Revascularization (Open or Percutaneous, Transcatheter) • Vascular Embolization and Occlusion • Intravascular Ultrasound Services • Endoscopy • Ligation • Other Procedures © 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Repair of Aneurysm Surgical Resection Grafting of Aneurysm © 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Femoral Angiogram The use of contrast medium makes the femoral artery visible. © 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Percutaneous Transluminal Coronary Angioplasty (PTCA) © 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Hemic and Lymphatic Systems Subsection • Headings include: • Spleen • General • Lymph Nodes and Lymphatic Channels © 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Spleen Heading • Subheadings include: • Excision • Repair • Laparoscopy • Introduction © 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

General Heading • Classifies bone marrow, stem cell, transplantation, and post-transplantation services and procedures • Subheadings include: • Bone Marrow or Stem Cell Services/Procedures • Transplantation and Post-Transplantation Cellular Infusions © 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Transplantation and Post-Transplantation Cellular Infusions Heading • Hematopoietic cell transplantation (HCT) • Autologous or allogeneic infusion of hematopoietic progenitor cells (HPC) obtained from bone marrow, peripheral blood apheresis, or umbilical cord blood • Codes are reported for: • Allogeneic, autologous, or HPC boost transplantations to restore bone marrow stem cells • Allogeneic lymphocyte infusions, used to treat chronic myelogenous leukemia © 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Lymph Nodes and Lymphatic Channels Heading • Classifies procedures performed on lymph nodes and lymphatic circulatory system (lymphatic channels) • Subheadings include: • • Incision Excision Limited Lymphadenectomy for Staging Laparoscopy Radical Lymphadenectomy (Radial Resection of Lymph Nodes) Introduction Other Procedures © 2020 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.