How To Use CPT Code 33266

CPT 33266 describes the endoscopic surgical procedure known as operative tissue ablation and reconstruction of the atria. 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 33266?

CPT 33266 is used to describe an endoscopic surgical procedure called operative tissue ablation and reconstruction of the atria. This procedure is performed to treat atrial fibrillation, a condition where the upper chambers of the heart, known as the atria, contract rapidly and irregularly. The goal of this procedure is to destroy the abnormal tissue in the atria and reconstruct them to restore the normal rhythm of the heart.

2. Official Description

The official description of CPT code 33266 is: ‘Endoscopy, surgical; operative tissue ablation and reconstruction of atria, extensive (eg, maze procedure), without cardiopulmonary bypass.’

3. Procedure

1. The provider begins by preparing and anesthetizing the patient.
2. Multiple ports are placed into the patient’s chest to allow for thoracoscopic assistance.
3. The provider creates incisions in both atria using techniques such as manual incision, radio waves, freezing, microwave, or ultrasound energy.
4. An endoscope is inserted to view the heart.
5. The provider opens the pericardium and ablates the right atrium, atrial septum, or left atrium together with the atrioventricular annulus.
6. The scar tissue that forms from the ablation does not conduct electricity and effectively interrupts the abnormal electrical impulses causing atrial fibrillation.
7. The provider sutures the holes in the atria together to allow them to hold blood and contract properly.
8. The endoscope is removed and the incisions are closed with sutures.

4. Qualifying circumstances

CPT 33266 is performed on patients with chronic atrial fibrillation or flutter. The procedure is extensive and involves the ablation and reconstruction of the atria. It is performed without the use of cardiopulmonary bypass. The patient must meet the criteria for the procedure and have a documented medical necessity for the treatment of their atrial fibrillation.

5. When to use CPT code 33266

CPT code 33266 should be used when the provider performs an endoscopic surgical procedure to correct chronic atrial fibrillation or flutter. This code includes the maze procedure, which interrupts the abnormal electrical impulses causing the irregular heart rhythm. It is important to review the procedure notes for details such as the placement of incisions in both atria and the use of various techniques for tissue ablation. CPT code 33266 should not be reported in conjunction with codes 32551, 33210, or 33211.

6. Documentation requirements

To support a claim for CPT 33266, the provider must document the following information:

• Diagnosis of chronic atrial fibrillation or flutter
• Details of the procedure, including the techniques used for tissue ablation and reconstruction
• Date of the procedure
• Start and end time of the procedure
• Any complications or additional procedures performed
• Signature of the provider

7. Billing guidelines

When billing for CPT 33266, ensure that the procedure meets the criteria for chronic atrial fibrillation or flutter. The procedure should be performed without cardiopulmonary bypass. It is important to review the documentation and procedure notes to accurately report the details of the procedure. CPT code 33266 should not be reported in conjunction with codes 32551, 33210, or 33211.

8. Historical information

CPT 33266 was added to the Current Procedural Terminology system on January 1, 2007. There have been no updates to the code since its addition. It was also added to the Inpatient Only (IPO) list for Medicare in 2017.

9. Examples

1. A patient with chronic atrial fibrillation undergoes endoscopic surgery for operative tissue ablation and reconstruction of the atria to restore normal heart rhythm.
2. An individual with atrial flutter undergoes the maze procedure using endoscopic techniques to correct the abnormal heart rhythm.
3. A provider performs operative tissue ablation and reconstruction of the atria without cardiopulmonary bypass for a patient with chronic atrial fibrillation.
4. An endoscopic surgical procedure is performed to treat atrial fibrillation in a patient with documented medical necessity.
5. A provider uses various techniques such as radio waves and freezing to ablate and reconstruct the atria in a patient with chronic atrial fibrillation.
6. An individual with chronic atrial flutter undergoes endoscopic surgery to correct the abnormal heart rhythm.
7. A provider performs operative tissue ablation and reconstruction of the atria without cardiopulmonary bypass to treat atrial fibrillation in a patient.
8. An endoscopic procedure is performed to ablate and reconstruct the atria in a patient with chronic atrial fibrillation.
9. A patient with atrial flutter undergoes the maze procedure using endoscopic techniques to restore normal heart rhythm.
10. An individual with chronic atrial fibrillation undergoes endoscopic surgery for operative tissue ablation and reconstruction of the atria without cardiopulmonary bypass.