Friday, October 10, 2014
Status Codes V42.2 Vs.V43.3 Confusion:
V42.2 – Heart valve replaced by transplant
V43.3 – Heart valve replaced by Other means
If the patient has a tissue valve (porcine, bovine, etc), it’s a v42.2.
Artificial valve is V43.3. An artificial valve requires the Coumadin, tissue valves typically do not.
Tissue Heart Valve:
Tissue valves are harvested from pig heart valves (porcine) or cow heart sac (bovine). These tissues are treated and neutralized so that the body will not reject them. Some are mounted on a frame or stent; others are used directly (stentless).
The lifetime of a tissue valve is typically 10 to 15 years, often less in younger patients. Over this time the valve will likely be degenerating to the point of requiring replacement. Because valve replacement surgery carries a significant risk of death, patient life expectancy is a major criterion in considering a tissue valve.
Mechanical Heart Valve:
The most widely used mechanical valves are made from pyrolytic carbon, which has been used for over 30 years. Most are bileaflet designs, meaning that they employ two carbon “leaflets” to regulate flow to a single direction.
The primary advantage of mechanical valves is that they will last a patient’s lifetime. Mechanical valves are preferred for patients with life expectancies beyond 10-15 years because they eliminate the mortality risk inherent in the replacement of a worn out tissue valve.