How To Use CPT Code 33251

CPT 33251 describes the operative ablation of a supraventricular arrhythmogenic focus or pathway using 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 33251?

CPT 33251 can be used to describe the operative ablation of a supraventricular arrhythmogenic focus or pathway using cardiopulmonary bypass. This code is used when a provider destroys a small area of the heart above the ventricles that is causing an abnormal heart rhythm. The procedure involves placing the patient on cardiopulmonary bypass to maintain circulation and oxygen content during the ablation.

2. Official Description

The official description of CPT code 33251 is: ‘Operative ablation of supraventricular arrhythmogenic focus or pathway (eg, Wolff-Parkinson-White, atrioventricular node re-entry), tract(s) and/or focus (foci); with cardiopulmonary bypass.’

3. Procedure

1. The provider incises the chest and exposes the heart.
2. If necessary, the patient is placed on cardiopulmonary bypass.
3. An electrophysiologist stimulates the heart to identify the area causing the abnormal heart rhythm.
4. The provider destroys the localized area of the heart using an electrical current, incision, or cryotherapy.
5. The electrophysiologist confirms the successful destruction of the area causing the abnormal heart rhythm.
6. The provider controls bleeding, weans the patient off bypass, and closes the incisions.

4. Qualifying circumstances

CPT 33251 is used for patients with a supraventricular arrhythmia caused by an abnormal focus or pathway above the ventricles of the heart. This procedure is performed by a provider who is capable of performing ablations and is typically done in conjunction with an electrophysiologist. Cardiopulmonary bypass is used during the procedure to maintain circulation and oxygenation.

5. When to use CPT code 33251

CPT code 33251 should be used when a provider performs operative ablation of a supraventricular arrhythmogenic focus or pathway using cardiopulmonary bypass. It is important to note that this code is specifically for procedures involving cardiopulmonary bypass. If the procedure is performed without cardiopulmonary bypass, a different code should be used.

6. Documentation requirements

To support a claim for CPT 33251, the provider must document the following information:

• Patient’s diagnosis and the need for ablation
• Details of the procedure, including the use of cardiopulmonary bypass
• Specific area of the heart targeted for ablation
• Confirmation of successful destruction of the arrhythmogenic focus or pathway
• Any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 33251, ensure that the procedure involves the use of cardiopulmonary bypass. It is important to follow the guidelines provided by the payer regarding documentation and coding for this procedure. Additionally, consider any applicable modifiers or additional codes that may be required for accurate billing.

8. Historical information

CPT 33251 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition. However, it is important to stay updated with any changes or revisions that may occur in the future.

9. Examples

1. A provider performs operative ablation of a supraventricular arrhythmogenic focus using cardiopulmonary bypass for a patient with Wolff-Parkinson-White syndrome.
2. During a surgical procedure, a provider destroys an abnormal pathway above the ventricles of the heart causing an abnormal heart rhythm using cardiopulmonary bypass.
3. A patient with atrioventricular node re-entry undergoes operative ablation of the pathway using cardiopulmonary bypass.
4. A provider performs ablation of a supraventricular arrhythmogenic focus with cardiopulmonary bypass for a patient with a history of recurrent arrhythmias.
5. During a cardiac surgery, a provider identifies and destroys a localized area of the heart causing an abnormal heart rhythm using cardiopulmonary bypass.
6. An electrophysiologist and a surgeon collaborate to perform operative ablation of a supraventricular arrhythmogenic focus using cardiopulmonary bypass for a patient with a complex arrhythmia.
7. A provider performs ablation of a supraventricular arrhythmogenic focus using cardiopulmonary bypass for a patient with a congenital heart defect.
8. During a surgical procedure, a provider destroys an abnormal pathway above the ventricles of the heart causing an abnormal heart rhythm using cardiopulmonary bypass.
9. A patient with atrioventricular node re-entry undergoes operative ablation of the pathway using cardiopulmonary bypass.
10. A provider performs ablation of a supraventricular arrhythmogenic focus with cardiopulmonary bypass for a patient with a history of recurrent arrhythmias.