How To Use CPT Code 33031

CPT 33031 describes the excision of the pericardium, the outer covering of the heart, either partially or completely, with the use of cardiopulmonary bypass. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 33031?

CPT 33031 is used to describe the surgical procedure in which the provider removes a portion or all of the pericardium, the outermost layer of the heart. This procedure may be performed in patients with constrictive pericarditis or calcified pericardium. The provider places the patient on cardiopulmonary bypass, which temporarily takes over the functions of the heart and lungs during the procedure.

2. Official Description

The official description of CPT code 33031 is the excision of the pericardium, either partially or completely, with the use of cardiopulmonary bypass.

3. Procedure

1. The provider prepares and anesthetizes the patient.
2. An incision is made over the sternum to access the chest cavity.
3. The provider gains access to the pericardium, the outermost covering of the heart.
4. The pericardium is excised either partially or completely.
5. A cardiopulmonary bypass unit is used to temporarily take over the functions of the heart and lungs.
6. The provider restores the natural circulation of blood via the heart, wires the sternum to allow it to join naturally, and closes the incision with sutures.

4. Qualifying circumstances

CPT 33031 is performed in patients with constrictive pericarditis or calcified pericardium. Constrictive pericarditis is a long-term inflammation of the pericardium, resulting in thickening, scarring, and muscle tightening. The procedure is performed by a provider who is appropriately trained and qualified to perform pericardiectomy with the use of cardiopulmonary bypass.

5. When to use CPT code 33031

CPT code 33031 should be used when the provider performs the excision of the pericardium, either partially or completely, with the use of cardiopulmonary bypass. It is important to note that CPT code 33031 should not be reported if the procedure is performed without cardiopulmonary bypass. In such cases, CPT code 33030 should be used instead.

6. Documentation requirements

To support a claim for CPT code 33031, the provider must document the following information:

• Patient’s diagnosis of constrictive pericarditis or calcified pericardium
• Description of the procedure performed, including whether the pericardium was excised partially or completely
• Use of cardiopulmonary bypass during the procedure
• Date of the procedure
• Any additional relevant details or complications encountered during the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 33031, ensure that the procedure was performed with the use of cardiopulmonary bypass. It is important to follow the specific guidelines provided by the payer to ensure accurate and appropriate billing. Additionally, it is important to note that CPT code 33031 should not be reported with other codes unless specified by the payer.

8. Historical information

CPT code 33031 was added to the Current Procedural Terminology system on January 1, 1990. In 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A provider performs a pericardiectomy, excising the pericardium completely with the use of cardiopulmonary bypass, in a patient with constrictive pericarditis.
2. A patient with calcified pericardium undergoes a pericardiectomy, with the provider excising the pericardium partially and utilizing cardiopulmonary bypass during the procedure.
3. In a complex case, a provider performs a pericardiectomy, excising the pericardium completely with the use of cardiopulmonary bypass, and explores the mediastinum for any additional abnormalities.
4. A patient with constrictive pericarditis undergoes a pericardiectomy, with the provider excising the pericardium partially and utilizing cardiopulmonary bypass during the procedure.
5. A provider performs a pericardiectomy, excising the pericardium completely with the use of cardiopulmonary bypass, in a patient with calcified pericardium.
6. In a challenging case, a provider performs a pericardiectomy, excising the pericardium partially with the use of cardiopulmonary bypass, and explores the mediastinum for any additional abnormalities.
7. A patient with calcified pericardium undergoes a pericardiectomy, with the provider excising the pericardium completely and utilizing cardiopulmonary bypass during the procedure.
8. A provider performs a pericardiectomy, excising the pericardium partially with the use of cardiopulmonary bypass, in a patient with constrictive pericarditis.