How To Use CPT Code 33418

CPT 33418 describes the percutaneous approach to repair a narrowed and stiff mitral 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 33418?

CPT 33418 can be used to describe a percutaneous approach to repair a narrowed and stiff mitral valve. This code is used when the provider uses a catheter inserted through the skin to access the affected area of the heart and repair the mitral valve. The procedure may also involve puncturing the septum, the wall between the atrium and left ventricle, to access the mitral valve. The provider may place an initial prosthesis, such as a clip prosthesis, to reduce the opening of the valve and decrease regurgitation of blood into the left atrium.

2. Official Description

The official description of CPT code 33418 is: ‘Transcatheter mitral valve repair, percutaneous approach, including transseptal puncture when performed; initial prosthesis.’ It is important to note that this code should not be reported in conjunction with code 93462 unless transapical puncture is performed.

3. Procedure

1. The provider prepares and anesthetizes the patient.
2. A catheter is inserted percutaneously through the skin in the groin area.
3. The provider guides the catheter through the femoral vein into the affected area of the heart.
4. The provider gains access to the mitral valve and may puncture the septum if necessary.
5. An initial prosthesis, such as a clip prosthesis, is placed in the mitral valve to reduce its opening and decrease regurgitation.
6. All instruments are removed, bleeding is stopped, and incisions are closed.

4. Qualifying circumstances

Patients eligible for CPT 33418 are those with a narrowed and stiff mitral valve that requires repair. The procedure is performed using a percutaneous approach, which involves inserting a catheter through the skin. The provider may also need to puncture the septum to access the mitral valve. It is important to note that CPT 33418 should not be reported in conjunction with code 93462 unless transapical puncture is performed.

5. When to use CPT code 33418

CPT code 33418 should be used when a provider performs a percutaneous approach to repair a narrowed and stiff mitral valve. It is important to ensure that the procedure meets the specific criteria outlined in the code description. If the procedure involves transapical puncture, code 93462 should be reported instead of CPT 33418.

6. Documentation requirements

To support a claim for CPT 33418, the provider must document the following information:

• Patient’s diagnosis indicating the need for mitral valve repair
• Details of the percutaneous approach used
• Whether transseptal puncture was performed
• Description of the initial prosthesis placed in the mitral valve
• Date of the procedure
• Any complications or additional procedures performed
• Signature of the provider

7. Billing guidelines

When billing for CPT 33418, ensure that the procedure meets the specific criteria outlined in the code description. It is important to note that CPT 33418 should not be reported in conjunction with code 93462 unless transapical puncture is performed. Follow the appropriate coding guidelines and modifiers when reporting this procedure.

8. Historical information

CPT 33418 was added to the Current Procedural Terminology system on January 1, 2015. It was later added to the Inpatient Only (IPO) list for Medicare in 2017.

9. Examples

1. A provider performs a percutaneous approach to repair a narrowed and stiff mitral valve using an initial prosthesis.
2. A patient undergoes a transcatheter mitral valve repair with transseptal puncture performed by a provider using an initial prosthesis.
3. A provider repairs a narrowed and stiff mitral valve using a percutaneous approach and places an initial prosthesis to reduce regurgitation.
4. A patient with a narrowed and stiff mitral valve undergoes a transcatheter mitral valve repair with transseptal puncture performed by a provider using an initial prosthesis.
5. A provider performs a percutaneous approach to repair a narrowed and stiff mitral valve and places an initial prosthesis to improve valve function.
6. A patient undergoes a transcatheter mitral valve repair with transseptal puncture performed by a provider to address a narrowed and stiff mitral valve using an initial prosthesis.
7. A provider repairs a narrowed and stiff mitral valve using a percutaneous approach and places an initial prosthesis to reduce regurgitation and improve valve function.
8. A patient with a narrowed and stiff mitral valve undergoes a transcatheter mitral valve repair with transseptal puncture performed by a provider to address the condition using an initial prosthesis.