02QG4ZE
Repair Mitral Valve to Atrioventricular Valve, Left with No Device, Percutaneous Endoscopic Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | 2 Heart and Great Vessels |
| Operation | Q Repair |
| Body Part | G Mitral Valve |
| Approach | 4 Percutaneous Endoscopic |
| Device | Z No Device |
| Qualifier | E Atrioventricular Valve, Left |
Operation Definition
Restoring, to the extent possible, a body part to its normal anatomic structure and function
Procedure Overview
Repair is the default root operation for fixing an abnormality of the heart or great vessels when no more specific term - like Replacement, Occlusion, or Restriction - describes what was done. It covers a wide range of interventions, from suturing a traumatic tear in the aorta to closing a congenital defect with the patient's own tissue rather than a device, to correcting an abnormal connection between vessels.
Because Repair is the catch-all category in this body system, it is used for many congenital heart surgeries in children, trauma repairs after chest injury, and corrections of structural problems that don't fit the more specialized definitions elsewhere in the classification. The unifying idea is restoring the anatomy toward its normal form and function using general surgical techniques such as suturing, patching with the patient's own tissue, or reconstructing shape.
Anatomy & Axis Detail
Mitral Valve
The mitral valve sits between the left atrium and left ventricle, and its two leaflets, chordae tendineae, and annulus must close tightly to keep oxygenated blood moving forward into the aorta rather than backward into the lungs. Repair here typically addresses degenerative prolapse, annular dilation, or ischemic tethering of the leaflets, and surgeons favor conservative reconstruction over replacement whenever the native tissue allows, since preserving the patient's own valve and subvalvular apparatus better protects long-term left ventricular function. Techniques range from leaflet resection and chordal transfer to annuloplasty ring placement, often performed on cardiopulmonary bypass through a median sternotomy or minimally invasive thoracotomy. Documentation should capture the specific defect corrected and whether a ring or band was implanted, since that detail can shift code selection toward a device-bearing value.
Approach: Percutaneous Endoscopic
Percutaneous Endoscopic combines a puncture through skin or mucous membrane with insertion of an endoscope to visualize the procedure internally, as in laparoscopic cholecystectomy. It is distinguished from plain Percutaneous by the presence of scope-guided visualization, and from Via Natural or Artificial Opening Endoscopic by its route being a new puncture rather than an existing orifice or stoma.
Qualifier: Atrioventricular Valve, Left
This qualifier identifies the left atrioventricular valve, functionally equivalent to the mitral valve, especially in complex congenital anatomy where standard valve names may not apply. It is distinguished from the right atrioventricular valve qualifier by side, and from the common atrioventricular valve qualifier, which applies only when the valve remains undivided.
Coding & Documentation
Coders should only reach for Repair after ruling out every more specific root operation that fits the documented objective, since ICD-10-PCS convention states a more precise term always takes priority over Repair when both could apply. This makes accurate code assignment dependent on close reading of the operative note for words like "patch," "suture," or "reconstruct" versus terms suggesting occlusion, replacement, or restriction. A common mistake is defaulting to Repair out of convenience when a synthetic patch or device was actually used, which should instead point toward Supplement or Replacement depending on the material and intent.