How To Use CPT Code 33474

CPT 33474 describes a specific surgical procedure performed on the pulmonary valve. 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 33474?

CPT 33474 is a code used to describe a surgical procedure performed on the pulmonary valve. This procedure involves accessing the pulmonary valve through the pulmonary artery and making incisions in the valve leaflets to enlarge the valve opening and correct pulmonary stenosis.

2. Official Description

The official description of CPT code 33474 is: ‘Valvotomy, pulmonary valve, open heart, with cardiopulmonary bypass.’

3. Procedure

1. The provider makes an incision to approach the heart, typically a median sternotomy.
2. Cardiopulmonary bypass (CPB) is initiated to temporarily take over the function of the heart and lungs.
3. An incision is made in the pulmonary artery above the level of the valve.
4. The provider inspects the valve and uses a scalpel to cut into the fused commissures, the junction between the leaflets.
5. Other scarring and thickened tissue may be removed as needed.
6. A dilator may be used to widen and increase anulus size, or patches may be placed on the pulmonary artery to enlarge its diameter.
7. Catheters and cannulas are removed, the aorta is vented to remove air, and the heart is defibrillated.
8. The patient is taken off CPB.
9. The incision in the pulmonary artery is closed, any instruments are removed, bleeding is checked, and the sternotomy incision is closed.

4. Qualifying circumstances

CPT 33474 is performed on patients with pulmonary stenosis, a condition characterized by the narrowing of the pulmonary valve. The procedure is typically performed by a cardiac surgeon and requires the use of cardiopulmonary bypass.

5. When to use CPT code 33474

CPT code 33474 should be used when a surgical valvotomy is performed on the pulmonary valve to correct pulmonary stenosis. It is important to ensure that the procedure is performed with cardiopulmonary bypass and that the patient meets the criteria for pulmonary valve intervention.

6. Documentation requirements

To support a claim for CPT 33474, the provider must document the following information:

• Patient’s diagnosis of pulmonary stenosis
• Details of the surgical procedure performed
• Date of the procedure
• Use of cardiopulmonary bypass
• Any additional procedures or interventions performed
• Any complications or adverse events
• Signature of the performing provider

7. Billing guidelines

When billing for CPT 33474, it is important to ensure that the procedure meets the criteria for pulmonary valve intervention and is performed with cardiopulmonary bypass. It should not be reported with other codes unless additional procedures or interventions are performed. It is also important to follow any specific billing guidelines provided by the payer.

8. Historical information

CPT 33474 was added to the Current Procedural Terminology system on January 1, 1990. The code underwent a change in description on January 1, 2015, and was also added to the Inpatient Only (IPO) list for Medicare in 2017.

9. Examples

1. A cardiac surgeon performing an open heart valvotomy on the pulmonary valve to correct pulmonary stenosis.
2. A patient with pulmonary stenosis undergoing a surgical procedure on the pulmonary valve with the use of cardiopulmonary bypass.
3. A surgical team performing a valvotomy on the pulmonary valve during an open heart surgery.
4. A patient with a narrowed pulmonary valve receiving a surgical intervention to enlarge the valve opening.
5. A cardiac surgeon using a scalpel to incise the pulmonary valve leaflets and correct pulmonary stenosis.
6. A procedure performed on the pulmonary valve to improve blood flow from the right ventricle to the lungs.
7. A surgical intervention to treat pulmonary stenosis and improve the function of the pulmonary valve.
8. A patient undergoing a valvotomy on the pulmonary valve to alleviate symptoms of pulmonary stenosis.
9. A surgical procedure performed on the pulmonary valve to address a congenital heart defect.
10. A cardiac surgeon performing an open heart valvotomy to correct a narrowed pulmonary valve.