How To Use CPT Code 33426

CPT 33426 describes a surgical procedure performed on the mitral valve to repair it and ensure proper closure, preventing the backflow of blood from the left ventricle to the left atrium. 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 33426?

CPT 33426 is a code used to describe a surgical procedure performed on the mitral valve. This procedure aims to repair the valve so that it can close properly and prevent the backflow of blood from the left ventricle to the left atrium. It is typically performed under general anesthesia, and it involves accessing the heart through an incision in the sternum. Cardiopulmonary bypass is used to temporarily take over the function of the heart and lungs during the procedure. The mitral valve is accessed through an incision over the left atrium, and a prosthetic ring is placed in the valve to reduce its opening. The incisions are then closed, and the patient is taken off the cardiopulmonary bypass.

2. Official Description

The official description of CPT code 33426 is: ‘Valvuloplasty, mitral valve, with cardiopulmonary bypass; with prosthetic ring.’

3. Procedure

1. The patient is administered general anesthesia.
2. An incision is made in the sternum to access the heart.
3. Cardiopulmonary bypass is established to temporarily take over the function of the heart and lungs.
4. An incision is made over the left atrium to access the mitral valve.
5. A prosthetic ring is placed in the mitral valve to reduce its opening.
6. The incisions are closed, and the patient is taken off the cardiopulmonary bypass.

4. Qualifying circumstances

CPT 33426 is performed on patients with mitral valve conditions such as stenosis or insufficiency. These conditions can lead to the failure of the valve to maintain the desired flow of blood from the left atrium to the left ventricle. Mitral stenosis is commonly caused by rheumatic heart disease. The procedure is typically performed by a qualified healthcare professional in a surgical setting.

5. When to use CPT code 33426

CPT code 33426 should be used when a surgical repair of the mitral valve is performed with the use of a prosthetic ring. It is important to ensure that the procedure involves cardiopulmonary bypass and is specifically targeted at the mitral valve. This code should not be used for other procedures or repairs involving different valves.

6. Documentation requirements

To support a claim for CPT 33426, the healthcare professional must document the following information:

• Patient’s diagnosis and the need for mitral valve repair
• Details of the surgical procedure performed, including the use of cardiopulmonary bypass and the placement of a prosthetic ring
• Date and duration of the procedure
• Any additional relevant details or complications encountered during the procedure
• Signature of the healthcare professional performing the procedure

7. Billing guidelines

When billing for CPT 33426, ensure that the procedure meets the specific requirements outlined in the code description. It is important to accurately document the use of cardiopulmonary bypass and the placement of a prosthetic ring. Additionally, be aware of any specific billing guidelines or modifiers that may apply to this procedure. It is also important to review any applicable insurance policies or guidelines to ensure proper reimbursement.

8. Historical information

CPT 33426 was added to the Current Procedural Terminology system on January 1, 1990. The code has not undergone any updates or changes since its addition. However, it is important to stay updated with any changes or revisions to the code in future editions of the CPT manual.

9. Examples

1. A patient with mitral stenosis undergoes a valvuloplasty procedure with the placement of a prosthetic ring on the mitral valve.
2. A healthcare professional performs a mitral valve repair using a prosthetic ring on a patient with mitral insufficiency.
3. A surgical team uses cardiopulmonary bypass to repair a patient’s mitral valve with the placement of a prosthetic ring.
4. A patient with a history of rheumatic heart disease undergoes a mitral valve repair procedure with the use of a prosthetic ring.
5. A qualified healthcare professional performs a valvuloplasty on a patient’s mitral valve, reducing its opening with the placement of a prosthetic ring.
6. A surgical team performs a mitral valve repair procedure with the use of a prosthetic ring, ensuring proper closure and preventing backflow of blood.
7. A patient with mitral valve stenosis undergoes a surgical repair with the placement of a prosthetic ring to improve valve function.
8. A healthcare professional performs a valvuloplasty on a patient’s mitral valve, using a prosthetic ring to repair and restore proper valve closure.
9. A surgical team repairs a patient’s mitral valve using a prosthetic ring, ensuring the prevention of blood backflow.
10. A qualified healthcare professional performs a mitral valve repair procedure with the use of a prosthetic ring, improving the patient’s cardiac function.