How To Use CPT Code 33269

CPT 33269 describes the exclusion of the left atrial appendage (LAA) using a thoracoscopic approach. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 33269?

CPT 33269 is used to describe the exclusion of the left atrial appendage (LAA) through a minimally invasive thoracoscopic surgical procedure. This procedure involves the removal or closure of the LAA to treat conditions such as atrial fibrillation or to reduce the risk of thromboembolic complications caused by blood clots.

2. Official Description

The official description of CPT code 33269 is the exclusion of the left atrial appendage, thoracoscopic, using any method such as excision, isolation via stapling, oversewing, ligation, plication, or clip.

3. Procedure

1. The provider begins the thoracoscopic procedure after appropriately prepping and anesthetizing the patient.
2. A thoracoscope, a thin, flexible tube with a light and a small video camera, is inserted through a small incision.
3. The provider locates the left atrial appendage (LAA), a small sac in the top left chamber of the heart.
4. The provider performs exclusion of the LAA using any method, such as excision, stapling, oversewing, ligation, plication, or clip placement.
5. Specialized tools designed for LAA exclusion may be used during the procedure.
6. After completing the exclusion, the provider removes the thoracoscope and any other tools.
7. The surgical wounds are closed, and the procedure is concluded.

4. Qualifying circumstances

CPT 33269 is performed when there is a need to exclude the left atrial appendage (LAA) in patients with conditions such as atrial fibrillation or to reduce the risk of thromboembolic complications caused by blood clots. It is important to note that CPT 33269 should not be reported in conjunction with other specific codes related to LAA exclusion.

5. When to use CPT code 33269

CPT code 33269 should be used when the provider performs a thoracoscopic exclusion of the left atrial appendage (LAA) using any method. It is important to ensure that the procedure is performed for the appropriate indications and that it is not reported with other specific codes related to LAA exclusion.

6. Documentation requirements

To support a claim for CPT 33269, the provider must document the following information:

• Indication for the left atrial appendage (LAA) exclusion procedure
• Details of the specific method used for LAA exclusion
• Date of the procedure
• Start and end time of the procedure
• Any specialized tools used during the procedure
• Any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 33269, ensure that the procedure meets the criteria for thoracoscopic exclusion of the left atrial appendage (LAA). It is important to follow the specific guidelines and not report CPT 33269 in conjunction with other specific codes related to LAA exclusion. Additional tips for reporting CPT 33269 may be provided by the payer or coding guidelines.

8. Historical information

CPT 33269 was added to the Current Procedural Terminology system on January 1, 2022. As of the provided information, there have been no updates or changes to the code since its addition.

9. Examples

1. A provider performs a thoracoscopic exclusion of the left atrial appendage (LAA) using excision for a patient with atrial fibrillation.
2. A patient undergoes a thoracoscopic exclusion of the left atrial appendage (LAA) with oversewing to reduce the risk of thromboembolic complications.
3. A provider performs a thoracoscopic exclusion of the left atrial appendage (LAA) using a clip for a patient with a history of blood clots.
4. A patient undergoes a thoracoscopic exclusion of the left atrial appendage (LAA) using stapling to treat atrial fibrillation.
5. A provider performs a thoracoscopic exclusion of the left atrial appendage (LAA) using plication for a patient at high risk of thromboembolic complications.
6. A patient undergoes a thoracoscopic exclusion of the left atrial appendage (LAA) using a combination of excision and ligation to reduce the risk of blood clots.
7. A provider performs a thoracoscopic exclusion of the left atrial appendage (LAA) using a specialized tool for a patient with atrial fibrillation.
8. A patient undergoes a thoracoscopic exclusion of the left atrial appendage (LAA) using a clip and oversewing to prevent thromboembolic complications.
9. A provider performs a thoracoscopic exclusion of the left atrial appendage (LAA) using excision and stapling for a patient with a history of blood clots.
10. A patient undergoes a thoracoscopic exclusion of the left atrial appendage (LAA) using plication and ligation to treat atrial fibrillation.