How To Use CPT Code 33363

CPT 33363 describes the procedure of transcatheter aortic valve replacement (TAVR/TAVI) using an open axillary artery approach. 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 33363?

CPT 33363 is a specific code used to describe the procedure of transcatheter aortic valve replacement (TAVR/TAVI) with a prosthetic valve using an open axillary artery approach. This means that the provider inserts a compressed prosthetic aortic valve into the axillary artery and advances it to the heart with the help of a catheter. The damaged aortic valve is replaced with the prosthetic valve, and imaging guidance is used to assist with the placement of the valve.

2. Official Description

The official description of CPT code 33363 is: ‘Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; open axillary artery approach.’

3. Procedure

1. The provider accesses the axillary artery by making an open incision in the general area of the shoulder.
2. A compressed prosthetic aortic valve is passed into the axillary artery and advanced to the heart using a catheter.
3. The provider preps the space, typically with a balloon catheter, and positions the valve at the site of the damaged aortic valve.
4. Imaging guidance is used to assist with navigating the vascular system and placing the valve.

4. Qualifying circumstances

CPT 33363 is performed when the patient requires a transcatheter aortic valve replacement (TAVR/TAVI) with a prosthetic valve using an open axillary artery approach. This procedure is typically performed on patients with aortic valve disease or other conditions that require the replacement of the aortic valve. The provider must access the axillary artery and use imaging guidance to assist with the placement of the prosthetic valve.

5. When to use CPT code 33363

CPT code 33363 should be used when the provider performs a transcatheter aortic valve replacement (TAVR/TAVI) with a prosthetic valve using an open axillary artery approach. This code is specific to this procedure and should not be used for other approaches or techniques.

6. Documentation requirements

To support a claim for CPT 33363, the provider must document the following information:

• Indication for the transcatheter aortic valve replacement (TAVR/TAVI) procedure
• Details of the open axillary artery approach
• Use of imaging guidance during the procedure
• Description of the prosthetic valve used
• Any additional procedures or services performed during the same session
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 33363, ensure that the procedure is performed using an open axillary artery approach. This code includes a variety of services, including imaging guidance. Modifier 62 should be used to indicate the involvement of two physicians in the procedure. It is important to review payer-specific guidelines and policies to ensure accurate and appropriate billing.

8. Historical information

CPT 33363 was added to the Current Procedural Terminology system on January 1, 2013. In 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A patient with severe aortic valve stenosis undergoes transcatheter aortic valve replacement (TAVR) using an open axillary artery approach.
2. A provider performs transcatheter aortic valve replacement (TAVR) with a prosthetic valve using an open axillary artery approach on a patient with aortic valve regurgitation.
3. During a TAVR procedure, the provider replaces a damaged aortic valve with a prosthetic valve using an open axillary artery approach.
4. A patient with aortic valve disease undergoes transcatheter aortic valve replacement (TAVR) with a prosthetic valve using an open axillary artery approach to improve their cardiac function.
5. A provider performs a transcatheter aortic valve replacement (TAVR) procedure using an open axillary artery approach on a patient with aortic valve insufficiency.
6. During a TAVR procedure, the provider accesses the axillary artery and replaces the damaged aortic valve with a prosthetic valve using an open approach.
7. A patient with aortic valve disease undergoes transcatheter aortic valve replacement (TAVR) with a prosthetic valve using an open axillary artery approach to alleviate their symptoms.
8. A provider performs transcatheter aortic valve replacement (TAVR) with a prosthetic valve using an open axillary artery approach on a patient with aortic valve calcification.
9. During a TAVR procedure, the provider replaces a diseased aortic valve with a prosthetic valve using an open axillary artery approach to restore normal blood flow.
10. A patient with aortic valve disease undergoes transcatheter aortic valve replacement (TAVR) with a prosthetic valve using an open axillary artery approach to improve their overall cardiac function.