021X4KQ – Bypass Thoracic Aorta, Ascending/Arch to Right Pulmonary Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach

Coding Notes

Active

Billable, valid for HIPAA-covered transactions

PCS Table

Section 0 Medical and Surgical
Body System 2 Heart and Great Vessels
Operation 1 Bypass
Body Part	Approach	Device	Qualifier
0 Coronary Artery, One Artery 1 Coronary Artery, Two Arteries 2 Coronary Artery, Three Arteries 3 Coronary Artery, Four or More Arteries	0 Open	8 Zooplastic Tissue 9 Autologous Venous Tissue A Autologous Arterial Tissue J Synthetic Substitute K Nonautologous Tissue Substitute	3 Coronary Artery 8 Internal Mammary, Right 9 Internal Mammary, Left C Thoracic Artery F Abdominal Artery W Aorta
0 Coronary Artery, One Artery 1 Coronary Artery, Two Arteries 2 Coronary Artery, Three Arteries 3 Coronary Artery, Four or More Arteries	0 Open	Z No Device	3 Coronary Artery 8 Internal Mammary, Right 9 Internal Mammary, Left C Thoracic Artery F Abdominal Artery
0 Coronary Artery, One Artery 1 Coronary Artery, Two Arteries 2 Coronary Artery, Three Arteries 3 Coronary Artery, Four or More Arteries	3 Percutaneous	4 Intraluminal Device, Drug-eluting D Intraluminal Device	4 Coronary Vein
0 Coronary Artery, One Artery 1 Coronary Artery, Two Arteries 2 Coronary Artery, Three Arteries 3 Coronary Artery, Four or More Arteries	4 Percutaneous Endoscopic	4 Intraluminal Device, Drug-eluting D Intraluminal Device	4 Coronary Vein
0 Coronary Artery, One Artery 1 Coronary Artery, Two Arteries 2 Coronary Artery, Three Arteries 3 Coronary Artery, Four or More Arteries	4 Percutaneous Endoscopic	8 Zooplastic Tissue 9 Autologous Venous Tissue A Autologous Arterial Tissue J Synthetic Substitute K Nonautologous Tissue Substitute	3 Coronary Artery 8 Internal Mammary, Right 9 Internal Mammary, Left C Thoracic Artery F Abdominal Artery W Aorta
0 Coronary Artery, One Artery 1 Coronary Artery, Two Arteries 2 Coronary Artery, Three Arteries 3 Coronary Artery, Four or More Arteries	4 Percutaneous Endoscopic	Z No Device	3 Coronary Artery 8 Internal Mammary, Right 9 Internal Mammary, Left C Thoracic Artery F Abdominal Artery
6 Atrium, Right	0 Open 4 Percutaneous Endoscopic	8 Zooplastic Tissue 9 Autologous Venous Tissue A Autologous Arterial Tissue J Synthetic Substitute K Nonautologous Tissue Substitute	P Pulmonary Trunk Q Pulmonary Artery, Right R Pulmonary Artery, Left
6 Atrium, Right	0 Open 4 Percutaneous Endoscopic	Z No Device	7 Atrium, Left P Pulmonary Trunk Q Pulmonary Artery, Right R Pulmonary Artery, Left
6 Atrium, Right	3 Percutaneous	Z No Device	7 Atrium, Left
7 Atrium, Left	0 Open 4 Percutaneous Endoscopic	8 Zooplastic Tissue 9 Autologous Venous Tissue A Autologous Arterial Tissue J Synthetic Substitute K Nonautologous Tissue Substitute Z No Device	P Pulmonary Trunk Q Pulmonary Artery, Right R Pulmonary Artery, Left S Pulmonary Vein, Right T Pulmonary Vein, Left U Pulmonary Vein, Confluence
7 Atrium, Left	3 Percutaneous	J Synthetic Substitute	6 Atrium, Right
K Ventricle, Right L Ventricle, Left	0 Open 4 Percutaneous Endoscopic	8 Zooplastic Tissue 9 Autologous Venous Tissue A Autologous Arterial Tissue J Synthetic Substitute K Nonautologous Tissue Substitute	P Pulmonary Trunk Q Pulmonary Artery, Right R Pulmonary Artery, Left
K Ventricle, Right L Ventricle, Left	0 Open 4 Percutaneous Endoscopic	Z No Device	5 Coronary Circulation 8 Internal Mammary, Right 9 Internal Mammary, Left C Thoracic Artery F Abdominal Artery P Pulmonary Trunk Q Pulmonary Artery, Right R Pulmonary Artery, Left W Aorta
P Pulmonary Trunk Q Pulmonary Artery, Right R Pulmonary Artery, Left	0 Open 4 Percutaneous Endoscopic	8 Zooplastic Tissue 9 Autologous Venous Tissue A Autologous Arterial Tissue J Synthetic Substitute K Nonautologous Tissue Substitute Z No Device	A Innominate Artery B Subclavian D Carotid
V Superior Vena Cava	0 Open 4 Percutaneous Endoscopic	8 Zooplastic Tissue 9 Autologous Venous Tissue A Autologous Arterial Tissue J Synthetic Substitute K Nonautologous Tissue Substitute Z No Device	P Pulmonary Trunk Q Pulmonary Artery, Right R Pulmonary Artery, Left S Pulmonary Vein, Right T Pulmonary Vein, Left U Pulmonary Vein, Confluence
W Thoracic Aorta, Descending	0 Open	8 Zooplastic Tissue 9 Autologous Venous Tissue A Autologous Arterial Tissue J Synthetic Substitute K Nonautologous Tissue Substitute	A Innominate Artery B Subclavian D Carotid F Abdominal Artery G Axillary Artery H Brachial Artery P Pulmonary Trunk Q Pulmonary Artery, Right R Pulmonary Artery, Left V Lower Extremity Artery
W Thoracic Aorta, Descending	0 Open	Z No Device	A Innominate Artery B Subclavian D Carotid P Pulmonary Trunk Q Pulmonary Artery, Right R Pulmonary Artery, Left
W Thoracic Aorta, Descending	4 Percutaneous Endoscopic	8 Zooplastic Tissue 9 Autologous Venous Tissue A Autologous Arterial Tissue J Synthetic Substitute K Nonautologous Tissue Substitute Z No Device	A Innominate Artery B Subclavian D Carotid P Pulmonary Trunk Q Pulmonary Artery, Right R Pulmonary Artery, Left
X Thoracic Aorta, Ascending/Arch	0 Open 4 Percutaneous Endoscopic	8 Zooplastic Tissue 9 Autologous Venous Tissue A Autologous Arterial Tissue J Synthetic Substitute K Nonautologous Tissue Substitute Z No Device	A Innominate Artery B Subclavian D Carotid P Pulmonary Trunk Q Pulmonary Artery, Right R Pulmonary Artery, Left