How To Use CPT Code 33502

CPT 33502 describes the procedure for repairing an anomalous coronary artery that originates from the pulmonary artery by ligation. 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 33502?

CPT 33502 can be used to describe the procedure performed to repair an anomalous coronary artery that arises irregularly from the pulmonary artery. This code specifically involves the ligation of the coronary artery close to its origin from the pulmonary artery. The purpose of this procedure is to prevent congestive heart failure and correct failure to thrive that may result from this congenital anomaly, particularly in infants.

2. Official Description

The official description of CPT code 33502 is: ‘Repair of anomalous coronary artery from pulmonary artery origin; by ligation.’

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. An incision is made in the chest, typically a median sternotomy.
3. The pericardium is incised to access the heart.
4. The provider examines the anatomy of the heart to identify the presence of an anomalous coronary artery arising from the pulmonary artery.
5. If an anomalous left coronary artery arising from the pulmonary artery (ALCAPA) is present, the provider performs simple ligation of the coronary artery close to its origin from the pulmonary artery.
6. If an anomalous right coronary artery is present, the provider repairs it in a similar fashion.
7. The provider removes any instruments, checks for bleeding, and closes the chest.

4. Qualifying circumstances

Patients who may require CPT 33502 are those with an anomalous coronary artery arising irregularly from the pulmonary artery. This congenital heart defect, also known as Bland White Garland syndrome, primarily affects the left coronary artery, although an anomalous right coronary artery is less common. The procedure is typically performed on infants to prevent congestive heart failure and correct failure to thrive resulting from this anomaly.

5. When to use CPT code 33502

CPT code 33502 should be used when a provider performs the repair of an anomalous coronary artery that originates from the pulmonary artery by ligation. This code is specific to the ligation procedure and should not be used for other methods of repair or for anomalies originating from different arteries.

6. Documentation requirements

To support a claim for CPT 33502, the provider must document the following information:

• Confirmation of the presence of an anomalous coronary artery arising from the pulmonary artery
• Description of the ligation procedure performed
• Date of the procedure
• Any additional relevant details or complications encountered during the procedure
• Signature of the performing provider

7. Billing guidelines

When billing for CPT 33502, ensure that the procedure performed is the repair of an anomalous coronary artery from the pulmonary artery origin by ligation. It is important to distinguish this code from other codes that involve different repair methods or anomalies originating from different arteries. There are no specific guidelines regarding reporting CPT 33502 with other codes.

8. Historical information

CPT 33502 was added to the Current Procedural Terminology system on January 1, 1990. The code description was later changed on January 1, 2006, to specify the repair of an anomalous coronary artery from the pulmonary artery origin by ligation. As of 2017, this procedure is listed under the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A provider performs the ligation of an anomalous left coronary artery arising from the pulmonary artery in an infant to prevent congestive heart failure.
2. A patient undergoes the ligation of an anomalous right coronary artery arising from the pulmonary artery to correct failure to thrive.
3. A provider repairs an anomalous left coronary artery arising from the pulmonary artery by ligation in an infant with Bland White Garland syndrome.
4. The ligation of an anomalous right coronary artery originating from the pulmonary artery is performed to prevent congestive heart failure in an infant.
5. A provider performs the ligation of an anomalous left coronary artery arising from the pulmonary artery in an infant with failure to thrive.
6. An infant undergoes the ligation of an anomalous right coronary artery arising from the pulmonary artery to correct Bland White Garland syndrome.
7. A provider repairs an anomalous left coronary artery arising from the pulmonary artery by ligation in an infant to prevent congestive heart failure.
8. The ligation of an anomalous right coronary artery originating from the pulmonary artery is performed to correct failure to thrive in an infant.
9. A provider performs the ligation of an anomalous left coronary artery arising from the pulmonary artery in an infant with Bland White Garland syndrome.
10. An infant undergoes the ligation of an anomalous right coronary artery arising from the pulmonary artery to prevent congestive heart failure.