Thanks everybody for joining Sean Botley-Valla, I'll just spend a couple minutes, we thought it'd be helpful to go over the congenital base codes. As Frank mentioned, you know, even among our group, the way we approach some of these things has evolved and we're all on the same page, we wanted to make sure we convey that to you guys, to our community, so I have no disclosures. So just as a reminder to everybody, these are the updated base codes, they're for congenital lesions only, and they were broken down into having normal versus abnormal native connections. And then there's a right heart cath, 93593, 938594, for normal and abnormal native connections, a left heart cath only, that was a new add-on that we had, and then a right and left heart cath, and again for normal and abnormal native connections. And so I think part of what we wanted to convey is the evolution of how we've looked at this, and how we kind of think about the abnormal native and native and normal connections, and I think for those of you that trained von Pragean, and I don't want to hopefully, you know, get people fired up about Andersonian versus von Pragean, but the von Pragean sort of approach of having alignments and connections I think helps here, and so the point is that somebody with normal, quote-unquote normal connections per CPT has both normal alignments and normal connections, and so that means the alignments are the vena cava connecting to the, flowing into the atria, and then the atria flowing blood flowing into the ventricles and then out to the great arteries, those have to be normal alignments, so IVC-SVC to the right atrium, then to the RV, then to the pulmonary artery and pulmonary veins, then to the LA-LV aorta, like we all know. There's also the connections, which is, you know, from a technical standpoint, the endocardial cushions connect the atrium to the ventricles, and the conus and the semilunar valves connect the ventricles to the great arteries. If those are abnormal, we would code it as an abnormal connection also. So kind of the take-home is that to have a normal connection, you have to have both normal alignments and connections, and then abnormal, either of them have to be abnormal, so for instance, here we'll talk about some of the, on the next slide, I just included this slide, by the way, for people that want to read through the specific descriptor, I don't think you need to go through the whole thing. The one point about this, though, is remember when the CPT descriptor, they're not all inclusive, they are typical, and so just because something's not specifically mentioned here obviously does not mean that only those lesions are the ones that can be considered abnormal, so please don't get too hung up on those descriptors. But here are some examples, right? Essentially the normal will be simple things like isolated ASDs, VSDs, PDAs, and co-arcs. We were actually discussing this as our group of congenital or inherited cardiomyopathies, and we all, not to steal anyone else's thunder, but felt like that was appropriate to consider to congenital, even if phenotypically they arise later, because you're born with it, you're born with a genetic defect, and then potentially also idiopathic pulmonary hypertension, that may be a little bit gray, as long as you consider it congenital, you just need to document that you consider it a congenital pulmonary hypertension, and then that would be a congenital cath with normal connections. And you know, to be honest, pretty much everything else is going to be abnormal, so valvar, PS, and AS, and whether it be simple valvar, you know, the two-month-old or six-month-old or half-a-month-old baby that comes in that's doing well, and a critical AS and PS all would be abnormal. AV canals, right, because that's an abnormal connection between the atrium and the ventricles, any cone or truncal defects obviously, TETs, truncated transpositions, whether it be D or SLL, veins, Epstein's root, and any surgical shunt or conduit, so obviously any surgical shunt or conduit that's creating an abnormal connection would be considered abnormal. And that's really it, we just, like I said, wanted to just highlight the fact that this has evolved over time, because in the past we've had some slightly different recommendations, and again, as Frank mentioned, these are all what we've come together as a consensus for the group. And if you have any questions, you can feel free to email us. Yeah, I'm a big Panthers hockey fan.

congenital lesions

heart catheterization procedures

normal connections

abnormal connections

heart structures