How To Use CPT Code 33141

CPT 33141 describes a procedure known as transmyocardial laser revascularization, which is performed by a healthcare provider during another open cardiac procedure. 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 33141?

CPT 33141 is a code used to describe the transmyocardial laser revascularization procedure. This procedure involves using a laser beam to create holes in the surface of the heart in order to encourage the growth of new blood vessels. It is performed by a healthcare provider during another open cardiac procedure, such as coronary artery bypass surgery.

2. Official Description

The official description of CPT code 33141 is: ‘Transmyocardial laser revascularization, by thoracotomy; performed at the time of other open cardiac procedure(s) (List separately in addition to code for primary procedure).’ This code should be used in conjunction with other codes for the primary procedure being performed.

3. Procedure

1. During the transmyocardial laser revascularization procedure, the healthcare provider accesses the heart through a thoracotomy incision in the chest cavity.
2. The provider then opens the pericardium, which is the sac that surrounds the heart, and identifies the area of the heart that is ischemic, meaning it is not receiving enough blood supply.
3. A laser probe is placed in contact with the epicardium, which is the inner layer of the pericardium, and the provider uses the laser beam to vaporize the myocardium, which is the middle muscular layer of the heart wall.
4. This creates small channels from the heart’s surface to the ventricular cavity, allowing for improved blood flow to the ischemic area.
5. The procedure may or may not be performed using cardiopulmonary bypass, which temporarily takes over the function of the heart and lungs during surgery.
6. After completing the transmyocardial laser revascularization, the provider closes the thoracotomy incision with sutures and dresses the wound.

4. Qualifying circumstances

CPT 33141 is performed when a healthcare provider needs to restore blood flow to the heart by creating channels in the myocardium using a laser beam. This procedure is typically performed at the same time as another open cardiac procedure, such as coronary artery bypass surgery. It is important to note that CPT 33141 should only be reported if there is an appropriate primary code for the other open heart procedure(s) being performed.

5. When to use CPT code 33141

CPT code 33141 should be used when the transmyocardial laser revascularization procedure is performed during another open cardiac procedure. It is important to ensure that there is a primary code for the primary procedure being performed in order to report CPT 33141 correctly.

6. Documentation requirements

In order to support a claim for CPT 33141, the healthcare provider must document the following information:

• The need for transmyocardial laser revascularization and the reason for performing the procedure
• Details of the primary procedure being performed
• Documentation of the thoracotomy incision and the use of the laser probe
• Any complications or additional procedures performed during the same encounter
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 33141, it is important to ensure that the procedure is performed at the same time as another open cardiac procedure. This code should be reported in addition to the primary procedure code. It is also important to note that payers may not reimburse for CPT 33141 if it is reported without an appropriate primary code for the other open heart procedure(s) being performed.

8. Historical information

CPT 33141 was added to the Current Procedural Terminology system on January 1, 2001. There have been no updates to the code since its addition. In 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A healthcare provider performs transmyocardial laser revascularization during a coronary artery bypass surgery to improve blood flow to the ischemic area of the heart.
2. During an open cardiac procedure, a provider uses a laser beam to create channels in the myocardium to encourage the growth of new blood vessels.
3. Transmyocardial laser revascularization is performed by a healthcare provider during a pericardiectomy to restore blood flow to the heart.
4. A patient undergoes transmyocardial laser revascularization during a repair and replacement of a heart valve to improve blood flow to the heart.
5. During an open cardiac procedure, a healthcare provider performs transmyocardial laser revascularization to treat ischemia in the heart.
6. A provider performs transmyocardial laser revascularization during a repair of an atrial septal defect to improve blood flow to the heart.
7. During a coronary artery bypass surgery, a healthcare provider uses a laser beam to create channels in the myocardium to promote the growth of new blood vessels.
8. Transmyocardial laser revascularization is performed during a pericardial window procedure to restore blood flow to the heart.
9. A patient undergoes transmyocardial laser revascularization during a repair of a heart valve to improve blood flow to the heart.
10. During an open cardiac procedure, a healthcare provider performs transmyocardial laser revascularization to treat ischemia in the heart.