How To Use CPT Code 33370

CPT 33370 describes the percutaneous placement and subsequent removal of cerebral embolic protection devices during a transcatheter aortic valve replacement (TAVR) 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 33370?

CPT 33370 is used to describe the percutaneous placement and subsequent removal of cerebral embolic protection devices during a transcatheter aortic valve replacement (TAVR) procedure. This code is specifically used when one or more cerebral embolic protection devices are placed to prevent clots and debris caused by the TAVR from reaching the brain. The procedure involves accessing the arterial system, catheterization, imaging, and radiological supervision and interpretation.

2. Official Description

The official description of CPT code 33370 is: ‘Transcatheter placement and subsequent removal of cerebral embolic protection device(s), including arterial access, catheterization, imaging, and radiological supervision and interpretation, percutaneous (List separately in addition to code for primary procedure).’ This code should be used in conjunction with the primary procedure code for the TAVR.

3. Procedure

1. Before beginning the TAVR procedure, the provider prepares the patient and ensures they are appropriately prepped and anesthetized.
2. The provider makes a small incision in the skin to access the target blood vessel.
3. An introducer sheath is placed in the vessel to provide access for the procedure.
4. A guide catheter is inserted through the introducer sheath and guided under imaging to reach the target location.
5. The provider delivers the cerebral embolic protection device(s) through the guide catheter to filter or divert clots and debris during the TAVR.
6. After the TAVR is completed, the provider removes the cerebral embolic protection device(s), any debris, the guide catheter, and the arterial sheath.
7. The arteriotomy (incision in the artery) is closed using pressure and suture or a closure device.

4. Qualifying circumstances

CPT 33370 is used when one or more cerebral embolic protection devices are percutaneously placed and subsequently removed during a TAVR procedure. This procedure is performed to prevent clots and debris caused by the TAVR from reaching the brain. It is important to note that this code should be used in conjunction with the primary procedure code for the TAVR.

5. When to use CPT code 33370

CPT code 33370 should be used when a provider performs the percutaneous placement and subsequent removal of cerebral embolic protection devices during a TAVR procedure. It is important to report this code in addition to the primary procedure code for the TAVR. This code should not be reported without the primary procedure code.

6. Documentation requirements

To support a claim for CPT 33370, the provider must document the following information:

• Documentation of the primary TAVR procedure
• Description of the cerebral embolic protection devices used
• Details of the arterial access, catheterization, imaging, and radiological supervision and interpretation
• Date and duration of the procedure
• Any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 33370, it is important to report it with the appropriate primary procedure code for the TAVR. This code should not be reported without the primary procedure code. Additionally, it is important to note that payers may require additional documentation or prior authorization for this procedure. It is recommended to review the specific billing guidelines of the payer to ensure accurate and timely reimbursement.

8. Historical information

CPT 33370 was added to the Current Procedural Terminology system on January 1, 2022. There have been no updates or changes to the code since its addition.

9. Examples

1. A provider performs a transcatheter aortic valve replacement (TAVR) procedure and percutaneously places a cerebral embolic protection device to prevent clots and debris from reaching the brain.
2. During a TAVR procedure, a provider places multiple cerebral embolic protection devices to filter or divert clots and debris.
3. A patient undergoes a TAVR procedure, and the provider subsequently removes the cerebral embolic protection device(s) after the procedure is completed.
4. As part of a TAVR procedure, a provider percutaneously places a cerebral embolic protection device and later removes it along with any debris.
5. During a TAVR procedure, a provider places a cerebral embolic protection device to ensure the patient’s safety and subsequently removes it without any complications.
6. A provider performs a TAVR procedure and utilizes a cerebral embolic protection device to prevent any clots or debris from reaching the brain. The device is successfully removed after the procedure.
7. During a TAVR procedure, a provider places a cerebral embolic protection device to protect the patient from potential complications. The device is carefully removed once the procedure is completed.
8. A patient undergoes a TAVR procedure, and the provider skillfully places a cerebral embolic protection device to minimize the risk of clots or debris. The device is later removed without any issues.