How To Use CPT Code 33422

CPT 33422 describes the surgical procedure performed on the mitral valve to repair its narrowed and stiff condition. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 33422?

CPT 33422 is used to describe a surgical procedure that aims to repair a narrowed and stiff mitral valve. The mitral valve is responsible for controlling the flow of blood from the left atrium to the left ventricle. During this procedure, the provider opens the chest and releases the stiff valve while the patient is supported by a heart-lung machine.

2. Official Description

The official description of CPT code 33422 is: ‘Valvotomy, mitral valve; open heart, with cardiopulmonary bypass.’

3. Procedure

1. The provider makes an incision in the chest and gains access to the heart by splitting the sternum.
2. The patient is placed on cardiopulmonary bypass, which maintains blood circulation and breathing while the heart is stopped for surgery.
3. The provider opens the left atrium and accesses the mitral valve.
4. Scar tissue between the valve leaflets is split, releasing the stiff valve.
5. The provider closes the left atrium, achieves hemostasis, and places drains in the mediastinum.
6. The sternum is rejoined, and the wound is closed in layers.

4. Qualifying circumstances

CPT 33422 is performed on patients with a narrowed and stiff mitral valve that requires surgical intervention. The procedure is typically carried out by a provider who is experienced in open-heart surgery and is supported by a heart-lung machine. The patient must meet specific criteria for this procedure to be necessary.

5. When to use CPT code 33422

CPT code 33422 should be used when a surgical valvotomy is performed on the mitral valve through an open-heart approach with the use of cardiopulmonary bypass. It is important to accurately document the details of the procedure to support the use of this code.

6. Documentation requirements

To support a claim for CPT 33422, the provider must document the following information:

• Patient’s diagnosis and the need for surgical intervention
• Details of the procedure, including the use of cardiopulmonary bypass
• Date and duration of the surgery
• Specific steps taken during the procedure, such as opening the left atrium, accessing the mitral valve, and releasing the stiff valve
• Closure of the left atrium, achievement of hemostasis, and placement of drains
• Rejoining of the sternum and closure of the wound
• Any additional relevant information or complications encountered during the procedure

7. Billing guidelines

When billing for CPT 33422, ensure that the procedure meets the criteria outlined in the official description. It is important to accurately document the details of the surgery and any additional procedures performed. Consider any specific billing guidelines provided by insurance companies or payers to ensure proper reimbursement.

8. Historical information

CPT 33422 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.

9. Examples

1. A patient undergoes open-heart surgery with cardiopulmonary bypass to repair a narrowed and stiff mitral valve.
2. A provider performs a valvotomy on the mitral valve using an open-heart approach and a heart-lung machine.
3. A surgical team releases a stiff mitral valve during a procedure that requires the use of cardiopulmonary bypass.
4. A patient with a narrowed and stiff mitral valve undergoes surgical intervention to improve valve function.
5. A provider repairs a narrowed and stiff mitral valve through an open-heart procedure with the assistance of a heart-lung machine.
6. A surgical team performs a valvotomy on the mitral valve to alleviate its narrowed and stiff condition.
7. A patient’s mitral valve is repaired through open-heart surgery, including the use of cardiopulmonary bypass.
8. A provider releases a stiff mitral valve during a surgical procedure that requires the patient to be on a heart-lung machine.
9. A surgical team performs a valvotomy on the mitral valve to address its narrowed and stiff state.
10. A patient undergoes open-heart surgery with the assistance of a heart-lung machine to repair a narrowed and stiff mitral valve.