How To Use CPT Code 33503

CPT 33503 describes the repair of an anomalous coronary artery that originates from the pulmonary artery. 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 33503?

CPT 33503 can be used to describe the repair of an anomalous coronary artery that arises irregularly from the pulmonary artery. This procedure involves ligating the abnormal coronary artery and placing a graft to restore circulation to the heart. It is important to note that modifier 63 should not be reported in conjunction with CPT 33503.

2. Official Description

The official description of CPT code 33503 is: ‘Repair of anomalous coronary artery from pulmonary artery origin; by graft, without cardiopulmonary bypass.’

3. Procedure

1. The provider begins by appropriately prepping and anesthetizing the patient.
2. A graft is harvested from a selected area, such as the carotid, subclavian, internal mammary, or saphenous vessels.
3. A small incision is made in the chest, typically through a median sternotomy.
4. The provider does not place the patient on cardiopulmonary bypass.
5. The anomalous coronary artery arising from the pulmonary artery is ligated.
6. A bypass graft, such as from the internal mammary artery to the coronary artery, is placed to restore circulation to the affected part of the heart.
7. The provider removes any instruments, checks for bleeding, and closes the chest incision.

4. Qualifying circumstances

Patients who may require CPT 33503 are those with an anomalous coronary artery arising from the pulmonary artery. This is a congenital heart defect that primarily affects the left coronary artery, although an anomalous right coronary artery is less common. The procedure is performed by a provider who ligates the abnormal coronary artery and places a graft to restore circulation to the heart.

5. When to use CPT code 33503

CPT code 33503 should be used when a provider performs the repair of an anomalous coronary artery that originates from the pulmonary artery by graft, without cardiopulmonary bypass. It is important to note that modifier 63 should not be reported in conjunction with this code.

6. Documentation requirements

To support a claim for CPT 33503, the provider must document the following information:

• Patient’s diagnosis of an anomalous coronary artery arising from the pulmonary artery
• Description of the procedure performed, including the use of a graft and the absence of cardiopulmonary bypass
• Date of the procedure
• Details of the graft harvested and its placement
• Any complications or additional procedures performed
• Signature of the provider

7. Billing guidelines

When billing for CPT 33503, ensure that the procedure meets the criteria of repairing an anomalous coronary artery from pulmonary artery origin by graft, without cardiopulmonary bypass. Modifier 63 should not be reported in conjunction with this code. It is important to review the specific billing guidelines of the payer to ensure accurate reporting and reimbursement.

8. Historical information

CPT 33503 was added to the Current Procedural Terminology system on January 1, 2006. There have been no updates to the code since its addition. It is worth noting that this procedure is listed under the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A provider performs the repair of an anomalous left coronary artery arising from the pulmonary artery by graft, without cardiopulmonary bypass.
2. A patient with a congenital heart defect undergoes the repair of an anomalous right coronary artery originating from the pulmonary artery using a graft, without cardiopulmonary bypass.
3. A provider ligates an anomalous coronary artery arising from the pulmonary artery and places a bypass graft from the internal mammary artery to the coronary artery to restore circulation to the heart.
4. A patient with an anomalous left coronary artery undergoes the repair procedure, which involves ligating the abnormal vessel and using a graft to restore blood flow to the heart.
5. A provider performs the repair of an anomalous coronary artery arising from the pulmonary artery by graft, without the use of cardiopulmonary bypass, in a patient with a congenital heart defect.
6. A patient with an anomalous right coronary artery undergoes the repair procedure, which involves ligating the abnormal vessel and placing a graft to restore blood flow to the heart.
7. A provider performs the repair of an anomalous coronary artery originating from the pulmonary artery using a graft, without cardiopulmonary bypass, in a patient with a congenital heart defect.
8. A patient with an anomalous left coronary artery undergoes the repair procedure, which involves ligating the abnormal vessel and using a graft to restore blood flow to the heart.
9. A provider ligates an anomalous coronary artery arising from the pulmonary artery and places a bypass graft from the internal mammary artery to the coronary artery to restore circulation to the heart.
10. A patient with an anomalous right coronary artery undergoes the repair procedure, which involves ligating the abnormal vessel and placing a graft to restore blood flow to the heart.