How To Use CPT Code 33430

CPT 33430 describes the replacement of the mitral valve with the use of cardiopulmonary bypass. 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 33430?

CPT 33430 is used to describe the surgical procedure of replacing the mitral valve in the heart. This code is specifically used when the replacement is performed with the assistance of cardiopulmonary bypass. The mitral valve is responsible for controlling the flow of blood from the left atrium to the left ventricle. When the valve becomes diseased or damaged, a replacement surgery may be necessary to restore proper function.

2. Official Description

The official description of CPT code 33430 is: ‘Replacement, mitral valve, with cardiopulmonary bypass.’

3. Procedure

1. The patient is administered general anesthesia to ensure comfort and unconsciousness during the procedure.
2. The surgeon makes a large incision in the chest, typically through the sternum, to gain access to the heart.
3. The patient is placed on cardiopulmonary bypass, which involves the use of a heart-lung machine to maintain circulation and breathing while the heart is temporarily stopped.
4. The surgeon accesses the mitral valve through a small incision on the left side of the heart.
5. The diseased or damaged mitral valve is removed.
6. A prosthetic or artificial valve is then implanted in place of the removed valve.
7. The incisions are closed, and the patient is taken off the heart-lung machine.
8. The patient’s postoperative stay in the hospital includes close monitoring of the functioning of the new valve to ensure the success of the surgery.

4. Qualifying circumstances

CPT 33430 is used when the mitral valve replacement procedure is performed with the assistance of cardiopulmonary bypass. This procedure is typically necessary when the mitral valve is narrowed (stenosis) or fails to prevent the reverse flow of blood (regurgitation). Stenosis can be caused by conditions such as rheumatic heart disease or calcification of the valve leaflets. Regurgitation may be the result of genetic disorders, cardiomyopathy, or ischemic heart disease.

5. When to use CPT code 33430

CPT code 33430 should be used when a surgeon performs a mitral valve replacement procedure with the aid of cardiopulmonary bypass. It is important to accurately document the use of cardiopulmonary bypass during the surgery to support the use of this code.

6. Documentation requirements

To support a claim for CPT 33430, the following documentation is required:

• Confirmation of the need for mitral valve replacement
• Description of the use of cardiopulmonary bypass during the procedure
• Date of the surgery
• Details of the surgical approach and technique
• Information about the prosthetic valve used for replacement
• Any additional procedures performed during the surgery
• Postoperative monitoring and care provided
• Signature of the surgeon performing the procedure

7. Billing guidelines

When billing for CPT 33430, it is important to ensure that the procedure was performed with the assistance of cardiopulmonary bypass. This information should be clearly documented in the medical records. Additionally, it is important to follow any specific billing guidelines provided by insurance companies or payers. It is also important to review any applicable modifiers that may need to be appended to the code for accurate billing.

8. Historical information

CPT code 33430 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 mitral valve replacement with cardiopulmonary bypass due to severe mitral regurgitation caused by cardiomyopathy.
2. A surgeon performs mitral valve replacement with cardiopulmonary bypass on a patient with rheumatic heart disease and severe mitral stenosis.
3. A patient with ischemic heart disease undergoes mitral valve replacement with cardiopulmonary bypass to address severe mitral regurgitation.
4. A prosthetic mitral valve is implanted in a patient with calcification of the mitral valve leaflets using cardiopulmonary bypass.
5. A surgeon performs mitral valve replacement with cardiopulmonary bypass on a patient with a genetic disorder causing mitral regurgitation.
6. A patient with severe mitral stenosis due to rheumatic heart disease undergoes mitral valve replacement with cardiopulmonary bypass.
7. A prosthetic mitral valve is implanted in a patient with severe mitral regurgitation caused by ischemic heart disease using cardiopulmonary bypass.
8. A surgeon performs mitral valve replacement with cardiopulmonary bypass on a patient with calcification of the mitral valve leaflets and severe mitral stenosis.
9. A patient with cardiomyopathy undergoes mitral valve replacement with cardiopulmonary bypass to address severe mitral regurgitation.
10. A prosthetic mitral valve is implanted in a patient with a genetic disorder causing severe mitral stenosis using cardiopulmonary bypass.