How To Use CPT Code 33465

CPT 33465 describes the replacement of the tricuspid valve with the patient on 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 33465?

CPT 33465 can be used to describe the surgical procedure in which the tricuspid valve is replaced with the patient on cardiopulmonary bypass. This code is used when the physician performs the necessary steps to remove the damaged valve and suture the prosthetic valve into place.

2. Official Description

The official description of CPT code 33465 is: ‘Replacement, tricuspid valve, with cardiopulmonary bypass.’

3. Procedure

1. After the patient is prepared and under anesthesia, the surgeon opens the chest, typically through a sternotomy.
2. An incision is made in the pericardium, which is the tissue surrounding the heart.
3. Cardiopulmonary bypass is established, temporarily taking over the function of the heart and lungs to maintain blood circulation and oxygenation during the surgery.
4. The right atrium is opened, and any debris is removed.
5. The surgeon cuts into the valve leaflets to assess the size of the prosthetic valve needed.
6. The prosthetic valve is sutured into place.
7. The necessary steps for closing the chest are taken by the surgeon.

4. Qualifying circumstances

CPT 33465 is performed on patients who require the replacement of their tricuspid valve. The tricuspid valve is composed of three triangular membranous flaps and is located at the opening of the right atrium into the right ventricle. The procedure is typically performed by a physician and requires the use of cardiopulmonary bypass.

5. When to use CPT code 33465

CPT code 33465 should be used when a physician performs the replacement of the tricuspid valve with the patient on cardiopulmonary bypass. It is important to ensure that the procedure meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT 33465, the physician must document the following information:

• Patient’s diagnosis necessitating the tricuspid valve replacement
• Details of the procedure, including the use of cardiopulmonary bypass
• Date of the surgery
• Any additional relevant information or complications encountered during the procedure
• Signature of the performing physician

7. Billing guidelines

When billing for CPT 33465, it is crucial to ensure that the procedure meets the specific criteria outlined in the code description. Additionally, consider any additional guidelines provided by payers or regulatory bodies. It is important to accurately report the procedure and any associated modifiers, if applicable.

8. Historical information

CPT 33465 was added to the Current Procedural Terminology system on January 1, 1990. The code has undergone changes, including being added to the Inpatient Only (IPO) list for Medicare in 2017.

9. Examples

1. A patient undergoes tricuspid valve replacement with cardiopulmonary bypass due to severe tricuspid regurgitation.
2. A surgeon performs tricuspid valve replacement with cardiopulmonary bypass on a patient with endocarditis.
3. A patient with congenital heart disease undergoes tricuspid valve replacement with cardiopulmonary bypass to improve cardiac function.
4. A physician replaces the tricuspid valve with cardiopulmonary bypass in a patient with tricuspid stenosis.
5. A patient with tricuspid valve dysfunction undergoes surgical replacement with cardiopulmonary bypass to alleviate symptoms and improve quality of life.
6. A surgeon performs tricuspid valve replacement with cardiopulmonary bypass on a patient with tricuspid valve prolapse.
7. A patient with tricuspid valve regurgitation undergoes surgical replacement with cardiopulmonary bypass to prevent further complications.
8. A physician replaces the tricuspid valve with cardiopulmonary bypass in a patient with tricuspid atresia.
9. A patient with tricuspid valve insufficiency undergoes tricuspid valve replacement with cardiopulmonary bypass to restore proper valve function.
10. A surgeon performs tricuspid valve replacement with cardiopulmonary bypass on a patient with tricuspid valve calcification.