Double outlet left ventricle
ICD-10 Q20.2 is a billable code used to indicate a diagnosis of double outlet left ventricle.
Double outlet left ventricle (DOLV) is a rare congenital heart defect characterized by both great arteries (aorta and pulmonary artery) arising from the left ventricle. This condition leads to significant hemodynamic alterations, as the right ventricle is typically underdeveloped and may not adequately support pulmonary circulation. DOLV can occur as an isolated defect or in conjunction with other congenital anomalies, such as ventricular septal defects (VSD) or coarctation of the aorta. Clinical presentation often includes cyanosis, heart failure, and poor growth in infants. Diagnosis is typically made through echocardiography, which reveals the abnormal anatomy and blood flow patterns. Surgical intervention is usually required to correct the defect, often involving the creation of a biventricular circulation or, in some cases, a univentricular approach. Long-term follow-up is essential due to the risk of arrhythmias and other complications associated with congenital heart disease.
Documentation must include detailed descriptions of the defect, associated anomalies, and clinical management plans. Growth and developmental assessments are also crucial.
Infants presenting with cyanosis, failure to thrive, or heart murmurs; pre-operative assessments for surgical intervention.
Pediatric coders must ensure that all congenital anomalies are documented and coded accurately to reflect the complexity of the condition.
Genetic counseling notes should include family history, potential genetic syndromes associated with DOLV, and any genetic testing results.
Cases where DOLV is part of a genetic syndrome, such as 22q11.2 deletion syndrome; counseling for parents regarding recurrence risks.
Genetic coders should be aware of the implications of chromosomal abnormalities that may co-occur with congenital heart defects.
Used during surgical intervention for DOLV.
Operative report detailing the surgical procedure and any complications.
Pediatric cardiology specialists must ensure accurate coding of the procedure.
Common associated anomalies include ventricular septal defects, coarctation of the aorta, and pulmonary stenosis. Accurate coding requires documentation of all associated conditions.
