How To Use CPT Code 33305

CPT 33305 describes the repair of a wound to the heart with the patient on a cardiopulmonary bypass (CPB) machine. 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 33305?

CPT 33305 can be used to describe the repair of a wound to the heart while the patient is on a cardiopulmonary bypass (CPB) machine. This code is used when the provider performs a thoracotomy or sternotomy to access the heart, inspects and repairs any wounds, and closes the incisions made during the procedure.

2. Official Description

The official description of CPT code 33305 is: ‘Repair of cardiac wound; with cardiopulmonary bypass.’

3. Procedure

1. The provider performs a thoracotomy or sternotomy to access the heart.
2. A rib spreader is used to allow access to the pericardium.
3. If necessary, cardiopulmonary bypass (CPB) is established.
4. The provider inspects the heart to identify and repair any wounds.
5. If needed, the provider may suture over a small pad or synthetic graft material to anchor the stitches and close a wound.
6. The patient is weaned off bypass, and incisions made to establish the bypass are closed.
7. Chest or drainage tubes may be inserted.

4. Qualifying circumstances

CPT 33305 is used when the provider needs to repair a wound to the heart while the patient is on a cardiopulmonary bypass (CPB) machine. This procedure is typically performed in emergency situations or when the provider needs a still operative field to repair the heart. The patient must be appropriately prepped and anesthetized for the procedure.

5. When to use CPT code 33305

CPT code 33305 should be used when the provider needs to repair a wound to the heart while the patient is on a cardiopulmonary bypass (CPB) machine. This code should not be used when the repair can be performed without the need for cardiopulmonary bypass.

6. Documentation requirements

To support a claim for CPT 33305, the provider must document the following information:

• Indication for the procedure and the need for repair of a cardiac wound
• Details of the procedure performed, including the approach used (thoracotomy or sternotomy)
• Use of cardiopulmonary bypass (CPB) and any complications encountered
• Description of the wound repaired and the technique used
• Details of any additional procedures performed, such as the use of synthetic graft material
• Documentation of the patient’s condition after the procedure and any post-operative care provided

7. Billing guidelines

When billing for CPT 33305, ensure that the repair of the cardiac wound is performed while the patient is on a cardiopulmonary bypass (CPB) machine. This code should not be reported if the repair can be performed without the need for cardiopulmonary bypass. It is important to follow the specific guidelines provided by the payer regarding the use of this code and any associated modifiers.

8. Historical information

CPT 33305 was added to the Current Procedural Terminology system on January 1, 1990. In 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A patient undergoes repair of a cardiac wound while on a cardiopulmonary bypass (CPB) machine after sustaining a stab wound to the heart in a traumatic incident.
2. A provider performs repair of a cardiac wound while the patient is on a cardiopulmonary bypass (CPB) machine during open-heart surgery to address a congenital heart defect.
3. A patient requires repair of a cardiac wound while on a cardiopulmonary bypass (CPB) machine following complications during a previous heart surgery.
4. A provider performs repair of a cardiac wound while the patient is on a cardiopulmonary bypass (CPB) machine during a coronary artery bypass graft procedure.
5. A patient undergoes repair of a cardiac wound while on a cardiopulmonary bypass (CPB) machine after experiencing a myocardial infarction.
6. A provider performs repair of a cardiac wound while the patient is on a cardiopulmonary bypass (CPB) machine during a heart transplant procedure.
7. A patient requires repair of a cardiac wound while on a cardiopulmonary bypass (CPB) machine following a severe cardiac trauma in a car accident.
8. A provider performs repair of a cardiac wound while the patient is on a cardiopulmonary bypass (CPB) machine during a valve replacement surgery.
9. A patient undergoes repair of a cardiac wound while on a cardiopulmonary bypass (CPB) machine after sustaining a gunshot wound to the heart.
10. A provider performs repair of a cardiac wound while the patient is on a cardiopulmonary bypass (CPB) machine during a procedure to address a cardiac tumor.