How To Use CPT Code 33404

CPT 33404 describes the construction of an apical-aortic conduit, also known as an aortic valve bypass. 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 33404?

CPT 33404 is used to describe the construction of an apical-aortic conduit, which is a procedure performed by a healthcare provider to alleviate symptoms caused by blood flow obstruction from the left ventricle of the heart. The provider creates a channel and valve to bypass the native aortic valve, allowing for improved blood flow.

2. Official Description

The official description of CPT code 33404 is the construction of an apical-aortic conduit, which involves creating a channel and valve to bypass the native aortic valve. This procedure is performed to reduce symptoms caused by blood flow obstruction from the left ventricle of the heart.

3. Procedure

1. The healthcare provider prepares and anesthetizes the patient, placing them in a supine position.
2. An incision is made between the fifth and sixth ribs to access the heart and reach the descending aorta.
3. The left lung is deflated to facilitate the procedure.
4. The provider clamps the aorta on one side and creates a slit in the pinched area.
5. A valve conduit is sutured into place, and the clamp is removed.
6. The pericardium is opened to expose the top of the heart.
7. A ring of sutures is created around the insertion site, and the suture ends are looped through a sewing ring on the left ventricle connector.
8. The patient is placed on cardiopulmonary bypass (CPB).
9. A circular portion of the myocardium is incised and removed.
10. The left ventricle connector is filled with saline and inserted into the opening.
11. The sutures are tied to secure the apex to the left ventricle connector.

4. Qualifying circumstances

CPT 33404 is performed on patients who experience symptoms due to blood flow obstruction from the left ventricle of the heart. The procedure involves creating an apical-aortic conduit to bypass the native aortic valve. It is typically performed by a healthcare provider in cases where other treatment options have been exhausted or are not suitable for the patient’s condition.

5. When to use CPT code 33404

CPT code 33404 should be used when a healthcare provider performs the construction of an apical-aortic conduit to alleviate symptoms caused by blood flow obstruction from the left ventricle of the heart. It is important to ensure that the procedure meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT 33404, the healthcare provider must document the following information:

• Patient’s symptoms and the need for the apical-aortic conduit construction
• Details of the procedure, including the specific steps performed
• Date and duration of the procedure
• Any complications or additional procedures performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 33404, it is important to ensure that the procedure meets the specific criteria outlined in the code description. The healthcare provider should also follow any additional billing guidelines provided by the payer. It is important to review the documentation requirements and ensure that all necessary information is included in the claim.

8. Historical information

CPT 33404 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 reimbursement.

9. Examples

1. A healthcare provider performs the construction of an apical-aortic conduit to alleviate symptoms of blood flow obstruction in a patient with aortic valve stenosis.
2. A patient with aortic regurgitation undergoes the construction of an apical-aortic conduit to improve blood flow and reduce symptoms.
3. A healthcare provider performs the procedure on a patient with a congenital heart defect to bypass the native aortic valve and improve cardiac function.
4. A patient with a history of failed aortic valve repair undergoes the construction of an apical-aortic conduit as a last resort treatment option.
5. A healthcare provider performs the procedure on a patient with severe aortic valve disease who is not a suitable candidate for traditional valve replacement.
6. A patient with symptoms of blood flow obstruction from the left ventricle of the heart undergoes the construction of an apical-aortic conduit to alleviate their symptoms and improve their quality of life.
7. A healthcare provider performs the procedure on a patient with aortic valve stenosis who is experiencing significant limitations in their daily activities due to reduced blood flow.
8. A patient with a history of multiple failed aortic valve repair surgeries undergoes the construction of an apical-aortic conduit as a final treatment option.
9. A healthcare provider performs the procedure on a patient with aortic valve disease who is not a suitable candidate for traditional valve repair or replacement.
10. A patient with symptoms of blood flow obstruction from the left ventricle of the heart undergoes the construction of an apical-aortic conduit to improve their cardiac function and alleviate their symptoms.