How To Use CPT Code 33460

CPT 33460 describes a surgical procedure performed on the tricuspid valve to treat regurgitation caused by vegetations on the valve from infective endocarditis. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 33460?

CPT 33460 is a code used to describe a surgical procedure performed on the tricuspid valve. This procedure involves the excision or removal of the tricuspid valve in its entirety. It is typically performed to treat regurgitation, which is the backflow of blood through the valve. Regurgitation is often caused by vegetations on the valve resulting from infective endocarditis.

2. Official Description

The official description of CPT code 33460 is: ‘Valvectomy, tricuspid valve, with cardiopulmonary bypass.’

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. The provider opens the chest, usually through sternotomy.
3. An incision is made in the pericardium, the tissue surrounding the heart.
4. Cardiopulmonary bypass is established to temporarily take over the function of the heart and lungs.
5. The provider opens the atrium and surgically removes the infected tricuspid valve.
6. Any instruments are removed, and the incision in the atrium is closed.
7. The patient is taken off cardiopulmonary bypass, and the provider checks for bleeding.
8. Finally, the chest is closed.

4. Qualifying circumstances

CPT 33460 is performed on patients with regurgitation of the tricuspid valve caused by vegetations on the valve from infective endocarditis. The procedure is typically performed by a qualified healthcare professional in a surgical setting. It requires the use of cardiopulmonary bypass to maintain circulation during the surgery.

5. When to use CPT code 33460

CPT code 33460 should be used when a valvectomy of the tricuspid valve is performed with the use of cardiopulmonary bypass. It is important to distinguish between CPT code 33460 and CPT code 33465, which is used for tricuspid valve removal with replacement with a prosthetic valve.

6. Documentation requirements

To support a claim for CPT code 33460, the healthcare professional must document the following information:

• Patient’s diagnosis of tricuspid valve regurgitation
• Details of the surgical procedure performed, including the use of cardiopulmonary bypass
• Date of the procedure
• Any complications or additional procedures performed
• Signature of the healthcare professional performing the procedure

7. Billing guidelines

When billing for CPT code 33460, ensure that the procedure was performed with the use of cardiopulmonary bypass. It is important to note that CPT code 33460 is listed under the Inpatient Only (IPO) list for Medicare, meaning it can only be billed for inpatient services. It should not be reported with other codes unless additional procedures were performed during the same surgical session.

8. Historical information

CPT code 33460 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 a valvectomy of the tricuspid valve with cardiopulmonary bypass to treat severe regurgitation caused by infective endocarditis.
2. A healthcare professional performs a valvectomy of the tricuspid valve with cardiopulmonary bypass on a patient with vegetations on the valve resulting from infective endocarditis.
3. A surgical team excises the tricuspid valve using cardiopulmonary bypass to treat regurgitation caused by infective endocarditis.
4. A patient with severe tricuspid valve regurgitation undergoes a valvectomy with the use of cardiopulmonary bypass to improve cardiac function.
5. A qualified healthcare professional performs a valvectomy of the tricuspid valve with cardiopulmonary bypass to address regurgitation caused by vegetations on the valve.
6. A surgical procedure is performed to remove the tricuspid valve using cardiopulmonary bypass to treat regurgitation caused by infective endocarditis.
7. A patient with infective endocarditis undergoes a valvectomy of the tricuspid valve with the use of cardiopulmonary bypass to eliminate regurgitation.
8. A healthcare professional excises the tricuspid valve using cardiopulmonary bypass to address severe regurgitation caused by vegetations on the valve.
9. A surgical team performs a valvectomy of the tricuspid valve with cardiopulmonary bypass to treat regurgitation resulting from infective endocarditis.
10. A patient undergoes a procedure to remove the tricuspid valve using cardiopulmonary bypass to alleviate regurgitation caused by vegetations on the valve.