Division of Mitral Valve, Perc Approach, Prosthetic Leaflet

This code represents a percutaneous approach to cutting or separating the mitral valve using a prosthetic leaflet device. The procedure involves accessing the mitral valve via catheter-based technique (typically transseptal or transapical) without open thoracotomy, with the division performed in conjunction with or facilitated by a prosthetic leaflet component. This is distinct from open surgical commissurotomy or balloon valvuloplasty.

This code applies when documentation explicitly confirms a percutaneous mitral valve division procedure in which a prosthetic leaflet is utilized as part of the intervention — for example, in certain transcatheter mitral valve repair or reconstruction procedures where leaflet augmentation or replacement components are employed alongside division. Supporting documentation should include operative/procedure notes specifying the percutaneous access route, the division of mitral valve tissue, and the use of a prosthetic leaflet device. This code would not apply if the approach is open or endoscopic, or if no prosthetic leaflet component is involved.

• Distinguish from repair vs. division: Do not confuse with mitral valve repair codes (root operation "Repair" — character 0) or replacement codes; "Division" (character 8) specifically requires cutting/separating valve tissue — confirm the root operation is supported by the operative note.
• Prosthetic leaflet qualifier is critical: The seventh character qualifier "Prosthetic Leaflet" differentiates this from a standard percutaneous division (qualifier "No Device" or "Zooplastic"); verify the procedure note explicitly documents use of a prosthetic leaflet component or the code defaults to the incorrect qualifier.
• Sequencing: When this procedure is performed in conjunction with other cardiac interventions (e.g., transcatheter mitral valve procedures), follow ICD-10-PCS sequencing guidelines to determine the principal procedure; all concurrent device placements or additional root operations should be coded separately.