How To Use CPT Code 33410

CPT 33410 describes the replacement of the patient’s heart valve with a stentless tissue valve. 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 33410?

CPT 33410 is used to describe the surgical procedure in which the patient’s heart valve is replaced with a stentless tissue valve. This valve is an artificial valve that is not attached to a stent or frame. The purpose of this procedure is to treat aortic valve stenosis or regurgitation, conditions in which the heart’s aortic valve is either narrowed or doesn’t close tightly, causing blood to leak back into the heart.

2. Official Description

The official description of CPT code 33410 is: ‘Replacement, aortic valve, open, with cardiopulmonary bypass; with stentless tissue valve.’

3. Procedure

1. The patient is administered general anesthesia.
2. The surgeon makes an incision through the sternum (median sternotomy) and opens the pericardium, the sac that contains the heart.
3. The patient is placed on a heart-lung machine (cardiopulmonary bypass) to maintain blood circulation and breathing during the surgery.
4. The surgeon makes an incision in the aorta, the main artery that carries oxygenated blood from the heart to the body, and removes the diseased aortic valve.
5. The surgeon selects a stentless tissue valve, seats it in place, and trims it as necessary.
6. The incision in the aorta is closed, and the heart-lung machine is removed.
7. An echocardiogram is performed to ensure the proper functioning of the new valve.
8. The patient is transferred to the recovery room for post-operative care.

4. Qualifying circumstances

CPT 33410 is performed on patients with aortic valve stenosis or regurgitation, conditions that require the replacement of the aortic valve. The procedure is typically performed by a surgeon and requires the use of a stentless tissue valve. It is important to note that this code is specific to the replacement of the aortic valve and should not be used for other types of valve replacements.

5. When to use CPT code 33410

CPT code 33410 should be used when a surgeon performs an open replacement of the aortic valve using a stentless tissue valve. It is important to ensure that the procedure meets the specific criteria outlined in the code description. If the procedure involves a different type of valve or a different approach, a different CPT code should be used.

6. Documentation requirements

To support a claim for CPT code 33410, the following documentation is required:

• Patient’s diagnosis of aortic valve stenosis or regurgitation
• Description of the procedure performed, including the use of a stentless tissue valve
• Date of the surgery
• Details of the surgical approach and technique
• Any additional procedures performed during the surgery
• Post-operative care instructions
• Signature of the performing surgeon

7. Billing guidelines

When billing for CPT code 33410, it is important to ensure that the procedure meets the specific criteria outlined in the code description. The use of a stentless tissue valve is a key factor in determining the appropriateness of this code. It is also important to follow any additional guidelines provided by the payer or coding guidelines. It is recommended to review the specific billing guidelines for CPT code 33410 to ensure accurate and appropriate billing.

8. Historical information

CPT code 33410 was added to the Current Procedural Terminology system on January 1, 2000. Since its addition, there have been no updates or changes to the code.

9. Examples

1. A patient with severe aortic valve stenosis undergoes open heart surgery for the replacement of the aortic valve with a stentless tissue valve.
2. A patient with aortic valve regurgitation undergoes open heart surgery for the replacement of the aortic valve with a stentless tissue valve.
3. A patient with both aortic valve stenosis and regurgitation undergoes open heart surgery for the replacement of the aortic valve with a stentless tissue valve.
4. A patient with a history of aortic valve replacement requires a reoperation due to valve dysfunction. The surgeon performs an open replacement of the aortic valve with a stentless tissue valve.
5. A patient with aortic valve stenosis and comorbidities undergoes open heart surgery for the replacement of the aortic valve with a stentless tissue valve.