How To Use CPT Code 33020

CPT 33020 describes the procedure for pericardiotomy, which involves the removal of a clot or foreign body from the pericardial space. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 33020?

CPT 33020 is used to describe the surgical procedure of pericardiotomy, specifically for the removal of a clot or foreign body from the pericardial space. This code is utilized when the provider makes an incision in the pericardium to gain access and remove the clot or foreign body. The procedure requires appropriate prepping and anesthesia of the patient.

2. Official Description

The official description of CPT code 33020 is: ‘Pericardiotomy for removal of clot or foreign body (primary procedure).’ This code falls within the range of surgical procedures on the pericardium, specifically between codes 33016 and 33050.

3. Procedure

1. The provider prepares and anesthetizes the patient for the procedure.
2. An approach is chosen to expose the pericardium, such as making a small incision by excising the xiphoid process and retracting the diaphragm downward.
3. An incision is made in the pericardium to allow access for the removal of the clot or foreign body.
4. The provider carefully removes the clot or foreign body from the pericardial space.
5. The wound is closed using sutures.

4. Qualifying circumstances

CPT 33020 is performed when there is a need to remove a clot or foreign body from the pericardial space. The procedure is typically indicated for patients who have experienced a pericardial effusion or other conditions that result in the presence of a clot or foreign body in the pericardium. It is important to note that this procedure is considered a primary procedure and may have specific qualifying circumstances that need to be met for appropriate billing and reimbursement.

5. When to use CPT code 33020

CPT code 33020 should be used when a provider performs a pericardiotomy to remove a clot or foreign body from the pericardial space. It is important to ensure that the procedure is documented accurately and meets the specific criteria outlined in the official description of the code. This code should not be used for other procedures or interventions performed on the pericardium that do not involve the removal of a clot or foreign body.

6. Documentation requirements

To support a claim for CPT 33020, the provider must document the following information:

• Patient’s diagnosis or condition necessitating the pericardiotomy
• Details of the procedure, including the approach used and the specific steps taken
• Description of the clot or foreign body removed
• Date of the procedure
• Any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 33020, it is important to ensure that the procedure performed aligns with the official description of the code. The provider should also follow any specific billing guidelines or requirements set forth by the payer. It is crucial to accurately document the procedure and any necessary supporting information to avoid claim denials or delays in reimbursement.

8. Historical information

CPT 33020 was added to the Current Procedural Terminology system on January 1, 1990. The code has undergone a Medicare change in 2017, where it was added under the Inpatient Only (IPO) list. No further updates or revisions have been made to the code since its addition.

9. Examples

1. A provider performs a pericardiotomy to remove a clot from the pericardial space in a patient who experienced a pericardial effusion.
2. During a surgical procedure, a provider discovers a foreign body in the pericardium and performs a pericardiotomy to remove it.
3. A patient presents with symptoms of pericarditis, and a pericardiotomy is performed to remove a clot causing the inflammation.
4. Following a traumatic injury, a provider identifies a foreign body in the pericardial space and performs a pericardiotomy to remove it.
5. A patient with a history of pericardial effusion undergoes a pericardiotomy to remove a clot that has formed in the pericardium.
6. During a cardiac surgery, a provider discovers a foreign body in the pericardial space and performs a pericardiotomy to remove it.
7. A patient with a known clotting disorder requires a pericardiotomy to remove a clot that has formed in the pericardial space.
8. Following a cardiac procedure, a provider identifies a foreign body in the pericardium and performs a pericardiotomy to remove it.
9. A patient presents with symptoms of cardiac tamponade, and a pericardiotomy is performed to remove a clot causing the compression.
10. During a diagnostic procedure, a provider discovers a foreign body in the pericardial space and performs a pericardiotomy to remove it.