Aortic Valve and Aorta Procedure

Please note this question was answered in 2014. The coding advice may or may not be outdated.

Question:

I need help with coding this case. The patient underwent a three-vessel bypass a couple of years ago. Now, he/she has returned because of ascending and arch aneurysm and needs aortic valve replacement. The physician performed the following procedures: 1. Redo sternotomy (33530), 2. Ascending and total-arch replacement with a 32 mm Gelweave graft under circulatory arrest and with proximal anastomosis at the sinotubular junction (33860, 33870), 3. Aortic valve replacement with a 27 mm Magna pericardial tissue valve (33405), 4. Saphenous vein interposition graft placed from the neoaorta to the right coronary graft (I don't have a clue), 5. Reimplantation of the right internal mammary artery free graft with aortic patch into the neoaorta (I don't have a clue), 6. Placement of atrial and ventricular temporary pacing wires (bundled no code), 7. Endoscopic vein harvest (33508). These are the only codes I could figure out: 33860, 33870, 33405, 33508, and 33530. I'm having trouble with procedures 4 and 5.

Question ID: 5986
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