How To Use CPT Code 33267

CPT 33267 describes the exclusion of the left atrial appendage (LAA) through an open surgical procedure. 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 33267?

CPT 33267 can be used to describe the exclusion of the left atrial appendage (LAA) through an open surgical procedure. This code is used when the provider performs the exclusion, such as by excision, isolation via stapling, oversewing, ligation, plication, or placing a clip, of the LAA. The procedure is typically performed to treat atrial fibrillation or reduce the likelihood of thromboembolic complications caused by blood clots.

2. Official Description

The official description of CPT code 33267 is: ‘Exclusion of left atrial appendage, open, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip).’ It is important to note that CPT code 33267 should not be reported in conjunction with other sternotomy or thoracotomy procedures performed during the same session, and it should not be reported in conjunction with specific other codes (33254, 33255, 33256, 33257, 33258, 33259, 33265, 33266, 33420, 33422, 33425, 33426, 33427, 33430).

3. Procedure

1. The provider begins the open procedure, such as by thoracotomy or sternotomy, after appropriately prepping and anesthetizing the patient.
2. For thoracotomy, the provider makes a long incision in the chest and spreads the ribs. For sternotomy, the provider makes an incision over the sternum and divides it to access the heart.
3. The provider approaches the left atrial appendage (LAA), a small, pouchlike sac in the top left chamber of the heart.
4. The provider performs exclusion of the LAA using any method, such as excision, isolation via stapling, oversewing, ligation, plication, or placing a clip.
5. After completing the exclusion, the provider closes the surgical wounds.

4. Qualifying circumstances

CPT 33267 is performed when there is a need to exclude the left atrial appendage (LAA) through an open surgical procedure. This procedure is typically performed to treat atrial fibrillation or reduce the likelihood of thromboembolic complications caused by blood clots. It is important to note that CPT 33267 should not be reported in conjunction with other sternotomy or thoracotomy procedures performed during the same session, and it should not be reported in conjunction with specific other codes (33254, 33255, 33256, 33257, 33258, 33259, 33265, 33266, 33420, 33422, 33425, 33426, 33427, 33430).

5. When to use CPT code 33267

CPT code 33267 should be used when the provider performs the exclusion of the left atrial appendage (LAA) through an open surgical procedure. It is important to note that this code should not be reported in conjunction with other sternotomy or thoracotomy procedures performed during the same session, and it should not be reported in conjunction with specific other codes (33254, 33255, 33256, 33257, 33258, 33259, 33265, 33266, 33420, 33422, 33425, 33426, 33427, 33430).

6. Documentation requirements

To support a claim for CPT 33267, the provider must document the following information:

• Indication for the exclusion of the left atrial appendage (LAA)
• Details of the open surgical procedure performed, including the specific method used for exclusion (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)
• Date of the procedure
• Any additional relevant information or findings during the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 33267, ensure that the exclusion of the left atrial appendage (LAA) is performed through an open surgical procedure. It is important to note that this code should not be reported in conjunction with other sternotomy or thoracotomy procedures performed during the same session, and it should not be reported in conjunction with specific other codes (33254, 33255, 33256, 33257, 33258, 33259, 33265, 33266, 33420, 33422, 33425, 33426, 33427, 33430).

8. Historical information

CPT 33267 was added to the Current Procedural Terminology system on January 1, 2022. It is important to note that this code has been added under the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A provider performs the exclusion of the left atrial appendage (LAA) through an open surgical procedure to treat atrial fibrillation in a patient.
2. A patient undergoes the exclusion of the left atrial appendage (LAA) through an open surgical procedure to reduce the likelihood of thromboembolic complications caused by blood clots.