February 2015 Q & A

Question: Heart Transplant - Congenital Versus Non-congenital

There has been much back and forth over the years as to whether or not congenital heart transplant patients should continue to be reported as congenital for heart catheterization coding purposes. Physicians state that “once congenital always congenital”, but I've understood from consultant recommendations that unless the new heart has a congenital defect or complex rerouting of vessels due to congenital cardiac anatomy, then all heart caths for transplant patients are coded as non-congenital. Can you please clarify?


Answer:

I agree with both statements, but from a coding perspective, we recommend coding NON-congenital after a transplant, UNLESS there are residual defects or complex rerouting of the vessels as you suggest.