There are two new codes for closure of a paravalvular leak:
93590 – Percutaneous transcatheter closure of paravalvular leak; initial occlusion device, mitral valve
93591 – initial occlusion device, aortic valve
+93592 – each additional occlusion device (List separately in addition to code form primary procedure)
A transapical puncture can be reported separately with CPT +93462 for both procedures.
A transseptal puncture, which is also reported with CPT +93462, can only be reported with CPT 93591.
Here’s the problem: Codes 93590 and 93591 were not added to the parenthetical note for code +93462 to list them as primary procedures. We’ll keep an eye out for an update to the errata.