How To Use CPT Code 33261

CPT 33261 describes the operative ablation of a ventricular arrhythmogenic focus with 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 33261?

CPT 33261 can be used to describe the operative ablation of a ventricular arrhythmogenic focus with the use of cardiopulmonary bypass. This code is used when a provider destroys a small area of the ventricle of the heart that is causing an abnormal heart rhythm. The procedure involves placing the patient on cardiopulmonary bypass to maintain the circulation of blood and the oxygen content of the body.

2. Official Description

The official description of CPT code 33261 is: ‘Operative ablation of ventricular arrhythmogenic focus with cardiopulmonary bypass.’

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. The provider makes an incision in the chest to expose the heart.
3. If necessary, the patient is placed on cardiopulmonary bypass.
4. An electrophysiologist stimulates the heart using electrodes to identify the area of the ventricle causing the abnormal heart rhythm.
5. The surgeon then destroys the localized area of the heart ventricle using electrical current or cryotherapy.
6. The electrophysiologist reassesses the heart to ensure the area causing the abnormal rhythm is destroyed.
7. The surgeon controls bleeding and closes the chest wall by suturing the layers of tissue together.

4. Qualifying circumstances

CPT 33261 is performed on patients with a ventricular arrhythmogenic focus, which is a localized area of the ventricle causing an abnormal heart rhythm. The procedure requires the use of cardiopulmonary bypass to maintain blood circulation and oxygen levels. It is typically performed by a surgeon and may involve the assistance of an electrophysiologist to identify the specific area of the heart causing the abnormal rhythm.

5. When to use CPT code 33261

CPT code 33261 should be used when a provider performs operative ablation of a ventricular arrhythmogenic focus with the use of cardiopulmonary bypass. It is important to ensure that the procedure meets the specific criteria outlined in the code description, including the use of cardiopulmonary bypass and the destruction of the localized area causing the abnormal heart rhythm.

6. Documentation requirements

To support a claim for CPT 33261, the provider must document the following information:

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

7. Billing guidelines

When billing for CPT 33261, ensure that the procedure meets the specific criteria outlined in the code description. It is important to document the use of cardiopulmonary bypass and the successful ablation of the ventricular arrhythmogenic focus. Additionally, be aware of any additional codes that may be necessary to report related services, such as intraoperative epicardial and endocardial pacing and mapping (CPT 93631) performed by an electrophysiologist.

8. Historical information

CPT 33261 was added to the Current Procedural Terminology system on January 1, 1990. The code was later added to the Inpatient Only (IPO) list for Medicare in 2017.

9. Examples

1. A surgeon performs operative ablation of a ventricular arrhythmogenic focus with cardiopulmonary bypass on a patient with recurrent ventricular tachycardia.
2. A patient with a ventricular arrhythmogenic focus undergoes operative ablation with cardiopulmonary bypass to treat their abnormal heart rhythm.
3. A provider uses CPT code 33261 to bill for the operative ablation of a ventricular arrhythmogenic focus with cardiopulmonary bypass during a complex cardiac surgery.
4. A surgeon destroys a localized area of the ventricle causing an abnormal heart rhythm using electrical current while the patient is on cardiopulmonary bypass.
5. An electrophysiologist identifies the area of the ventricle causing the abnormal heart rhythm, and a surgeon performs operative ablation with cardiopulmonary bypass to treat the condition.
6. A patient with a ventricular arrhythmogenic focus undergoes operative ablation with cardiopulmonary bypass to restore a normal heart rhythm.
7. A surgeon performs operative ablation of a ventricular arrhythmogenic focus with cardiopulmonary bypass on a patient with refractory ventricular tachycardia.
8. A provider uses CPT code 33261 to bill for the operative ablation of a ventricular arrhythmogenic focus with cardiopulmonary bypass during a complex cardiac procedure.
9. An electrophysiologist stimulates the heart and identifies the area causing the abnormal heart rhythm, and a surgeon performs operative ablation with cardiopulmonary bypass to eliminate the arrhythmia.
10. A patient with a ventricular arrhythmogenic focus undergoes operative ablation with cardiopulmonary bypass to correct their abnormal heart rhythm.