How To Use CPT Code 33289

CPT 33289 describes the procedure for the transcatheter implantation of a wireless pulmonary artery pressure sensor for long-term hemodynamic monitoring. 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 33289?

CPT 33289 is used to describe the procedure for the implantation of a wireless pulmonary artery pressure sensor. This sensor is permanently implanted into the pulmonary artery during a catheterization procedure. The purpose of this procedure is to monitor pulmonary artery pressures and calibrate the sensor for long-term hemodynamic monitoring. The procedure includes right heart catheterization, selective pulmonary catheterization, radiological supervision and interpretation, and pulmonary artery angiography, if performed.

2. Official Description

The official description of CPT code 33289 is: ‘Transcatheter implantation of wireless pulmonary artery pressure sensor for long-term hemodynamic monitoring, including deployment and calibration of the sensor, right heart catheterization, selective pulmonary catheterization, radiological supervision and interpretation, and pulmonary artery angiography, when performed.’

3. Procedure

1. The provider begins by preparing the patient and cleaning the skin with an antiseptic solution.
2. An incision is made in the femoral vein, and an introducer sheath is inserted over a flexible guidewire under fluoroscopic guidance.
3. A balloon-tipped pulmonary artery catheter is passed through the sheath and advanced to a wedge position in the left or right pulmonary artery.
4. Pulmonary artery and pulmonary wedge pressures are measured, and a pulmonary artery angiogram is performed to identify the target implant site.
5. A sensor delivery guidewire is inserted through the pulmonary artery catheter and across the target site for the implant.
6. The pulmonary artery catheter is removed, and the sensor delivery catheter is guided into position at the implant target site.
7. The sensor is released, and the delivery catheter is slowly removed under fluoroscopic guidance.
8. The pulmonary artery catheter is reinserted, and the PA pressure is measured.
9. The provider programs the mean PA pressure and cardiac output baselines and takes baseline readings.
10. The PA catheter and introducer sheath are removed, and the incision is closed.

4. Qualifying circumstances

CPT 33289 is performed on patients who require long-term hemodynamic monitoring. The procedure is indicated for patients with conditions such as congestive heart failure, where monitoring pulmonary artery pressures is necessary to assess the heart’s pumping capacity, blood pressure, and other heart functions. The patient must meet the criteria for right heart catheterization and selective pulmonary catheterization, and the target implant site must meet the manufacturer’s specifications.

5. When to use CPT code 33289

CPT code 33289 should be used when a provider performs the transcatheter implantation of a wireless pulmonary artery pressure sensor for long-term hemodynamic monitoring. This code should not be reported in conjunction with other codes that describe similar procedures or services. It is important to review the documentation and ensure that the procedure meets the specific requirements outlined in the code description.

6. Documentation requirements

To support a claim for CPT 33289, the provider must document the following information:

• Patient’s diagnosis and the need for long-term hemodynamic monitoring
• Specific details of the procedure, including the deployment and calibration of the sensor
• Date and duration of the procedure
• Results of the right heart catheterization, selective pulmonary catheterization, and pulmonary artery angiography, if performed
• Baseline readings and programming of the sensor
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 33289, ensure that the procedure meets the specific requirements outlined in the code description. It is important to review the documentation and ensure that the procedure is not reported with other codes that describe similar procedures or services. Providers should follow the appropriate coding guidelines and modifiers, if applicable, to accurately report the procedure.

8. Historical information

CPT 33289 was added to the Current Procedural Terminology system on January 1, 2019. There have been no updates to the code since its addition.

9. Examples

1. A patient with congestive heart failure undergoes the transcatheter implantation of a wireless pulmonary artery pressure sensor for long-term hemodynamic monitoring.
2. A provider performs the procedure on a patient with pulmonary hypertension to monitor their pulmonary artery pressures.
3. A patient with a history of heart disease undergoes the procedure to assess their heart’s pumping capacity and blood pressure.
4. A provider implants the wireless sensor in a patient with a recent heart transplant to monitor their heart’s function.
5. A patient with a complex cardiac condition undergoes the procedure to monitor their hemodynamic status and guide their treatment plan.
6. A provider performs the procedure on a patient with a congenital heart defect to monitor their pulmonary artery pressures and assess the effectiveness of their treatment.
7. A patient with severe heart failure undergoes the procedure to monitor their response to medication and adjust their treatment accordingly.
8. A provider implants the wireless sensor in a patient with a history of recurrent heart attacks to monitor their cardiac function and detect any signs of worsening heart disease.
9. A patient with a history of arrhythmias undergoes the procedure to monitor their heart’s electrical activity and assess the effectiveness of their antiarrhythmic medications.
10. A provider performs the procedure on a patient with a ventricular assist device to monitor their hemodynamic status and ensure the device is functioning properly.