How To Use CPT Code 33468

CPT 33468 describes a surgical procedure performed on the tricuspid valve to correct the displacement of the septal and posterior leaflets in Ebstein anomaly. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 33468?

CPT 33468 is a code used to describe a surgical procedure performed on the tricuspid valve to correct the displacement of the septal and posterior leaflets in Ebstein anomaly. This procedure involves repositioning and plication of the tricuspid valve to restore its proper function.

2. Official Description

The official description of CPT code 33468 is: ‘Tricuspid valve repositioning and plication for Ebstein anomaly.’

3. Procedure

1. The surgeon opens the chest, typically through a sternotomy, and gains access to the heart.
2. An incision is made in the pericardium, the tissue surrounding the heart.
3. The surgeon then makes an incision in the right atrium to access the tricuspid valve.
4. The atrial septal defect, if present, is closed with a patch.
5. The surgeon uses sutures to pull the tricuspid valve annulus and leaflets together, or may detach and relocate the leaflets at the annulus.
6. Annuloplasty, a surgical repair of the annulus, may also be performed.
7. After ensuring there is no bleeding, the surgeon closes the incision in the atrium and then closes the chest.

4. Qualifying circumstances

CPT 33468 is performed in patients with Ebstein anomaly, a congenital defect characterized by the displacement of the septal and posterior leaflets of the tricuspid valve. This procedure is indicated for patients with symptomatic Ebstein defect who require surgical intervention to correct the tricuspid valve displacement.

5. When to use CPT code 33468

CPT code 33468 should be used when a surgeon performs tricuspid valve repositioning and plication for Ebstein anomaly. It is important to note that this code is specific to the surgical correction of tricuspid valve displacement in patients with Ebstein anomaly and should not be used for other tricuspid valve procedures.

6. Documentation requirements

To support a claim for CPT 33468, the surgeon must document the following information:

• Diagnosis of Ebstein anomaly
• Description of the procedure performed, including details of tricuspid valve repositioning and plication
• Date of the surgery
• Any additional procedures performed, such as closure of atrial septal defect or annuloplasty
• Any complications or unexpected findings during the surgery
• Signature of the surgeon

7. Billing guidelines

When billing for CPT 33468, ensure that the procedure performed is tricuspid valve repositioning and plication for Ebstein anomaly. It is important to follow the specific guidelines and documentation requirements set forth by the payer. It is also important to review any applicable coding guidelines and modifiers that may be required for accurate billing and reimbursement.

8. Historical information

CPT 33468 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 with symptomatic Ebstein anomaly undergoes tricuspid valve repositioning and plication to correct the displacement of the septal and posterior leaflets.
2. A surgeon performs tricuspid valve repositioning and plication for a patient with severe tricuspid insufficiency due to Ebstein anomaly.
3. In a complex case of Ebstein anomaly, a surgical team performs tricuspid valve repositioning and plication to restore proper tricuspid valve function.
4. A pediatric patient with Ebstein anomaly undergoes tricuspid valve repositioning and plication to improve cardiac function and quality of life.
5. A surgeon performs tricuspid valve repositioning and plication for a patient with Ebstein anomaly who has failed conservative management.
6. In a minimally invasive approach, a surgeon performs tricuspid valve repositioning and plication using robotic-assisted techniques for a patient with Ebstein anomaly.
7. A patient with Ebstein anomaly and significant tricuspid regurgitation undergoes tricuspid valve repositioning and plication to reduce the severity of the regurgitation.
8. A surgeon performs tricuspid valve repositioning and plication for a patient with Ebstein anomaly who presents with symptoms of heart failure.
9. In a revision surgery, a surgeon performs tricuspid valve repositioning and plication to correct residual tricuspid valve displacement in a patient with Ebstein anomaly.
10. A patient with Ebstein anomaly and severe tricuspid stenosis undergoes tricuspid valve repositioning and plication to relieve the obstruction and improve cardiac function.