How To Use CPT Code 33505

CPT 33505 describes the repair of an anomalous coronary artery from the pulmonary artery origin, specifically through the construction of an intrapulmonary artery tunnel. 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 33505?

CPT 33505 can be used to describe a surgical procedure that involves repairing an anomalous coronary artery that originates from the pulmonary artery. The procedure specifically includes the creation of an intrapulmonary artery tunnel, known as the Takeuchi procedure. This surgical intervention is typically performed to treat congestive heart failure, particularly in infants with congenital heart defects, although it may also be necessary for adults in certain cases.

2. Official Description

The official description of CPT code 33505 is: ‘Repair of anomalous coronary artery from pulmonary artery origin; with construction of intrapulmonary artery tunnel (Takeuchi procedure).’ This code is specifically used to report the surgical repair of an anomalous coronary artery that originates from the pulmonary artery, utilizing the Takeuchi procedure to create an intrapulmonary artery tunnel.

3. Procedure

1. The surgical procedure begins with appropriate patient preparation and anesthesia administration.
2. The provider makes an incision in the chest, typically through a median sternotomy.
3. If necessary, the patient may be placed on cardiopulmonary bypass (CPB) to temporarily take over the function of the heart and lungs.
4. An incision is made in the main pulmonary artery to access the anomalous origin of the coronary artery.
5. A flap is created from the pulmonary artery, which is then used to construct a tunnel inside the pulmonary artery trunk.
6. This flap is attached to the anomalous coronary origin, creating a connection between the tunnel and the aorta through a side-to-side anastomosis.
7. The pulmonary artery is closed or patched using tissue from the pericardium or a polytetrafluoroethylene (PTFE) graft.
8. If CPB was utilized, the patient is removed from bypass at this point.
9. The surgical instruments are removed, and the provider checks for any bleeding before closing the chest incision.

4. Qualifying circumstances

CPT 33505 is typically performed on patients with congenital heart defects or other conditions that result in an anomalous coronary artery originating from the pulmonary artery. The procedure is indicated for the treatment of congestive heart failure. It is important to note that this surgical intervention requires the expertise of a qualified healthcare professional with experience in performing the Takeuchi procedure.

5. When to use CPT code 33505

CPT code 33505 should be used when reporting the repair of an anomalous coronary artery from the pulmonary artery origin using the Takeuchi procedure. This code is specifically applicable to cases where an intrapulmonary artery tunnel is constructed to redirect the coronary artery to the aorta. It is important to ensure that the procedure performed aligns with the specific details outlined in the code description.

6. Documentation requirements

To support a claim for CPT 33505, the healthcare provider must document the following information:

• Patient’s diagnosis and indication for the surgical intervention
• Description of the specific steps performed during the procedure, including the creation of the intrapulmonary artery tunnel
• Date of the surgery
• Any additional details or complications encountered during the procedure
• Signature of the healthcare provider performing the surgery

7. Billing guidelines

When billing for CPT 33505, it is important to ensure that the procedure performed aligns with the specific details outlined in the code description. Additionally, it is crucial to follow any specific billing guidelines provided by the payer or relevant coding guidelines. Modifier usage should be in accordance with the payer’s requirements. It is also important to note that CPT code 33505 should not be reported with modifier 63 when performed in conjunction with the repair of an anomalous coronary artery by translocation from the pulmonary artery to the aorta (CPT codes 33506 and 33507).

8. Historical information

CPT code 33505 was added to the Current Procedural Terminology system on January 1, 2006. Since its addition, there have been no updates or changes to the code.

9. Examples

1. A pediatric cardiac surgeon performs CPT 33505 to repair an anomalous coronary artery from the pulmonary artery origin in an infant with congenital heart defects.
2. An adult patient with congestive heart failure undergoes CPT 33505 to address an anomalous coronary artery originating from the pulmonary artery.
3. A surgical team utilizes CPT 33505 to construct an intrapulmonary artery tunnel and redirect an anomalous coronary artery to the aorta in a patient with a complex congenital heart defect.
4. A patient with a history of congenital heart disease undergoes CPT 33505 to repair an anomalous coronary artery originating from the pulmonary artery, improving their cardiac function.
5. A skilled cardiovascular surgeon performs CPT 33505 to address an anomalous coronary artery from the pulmonary artery origin in a young adult with symptoms of congestive heart failure.
6. In a complex surgical procedure, CPT 33505 is utilized to create an intrapulmonary artery tunnel and redirect an anomalous coronary artery to the aorta, effectively treating a patient’s congenital heart defect.
7. A team of cardiac specialists performs CPT 33505 to repair an anomalous coronary artery originating from the pulmonary artery in a patient with severe heart failure.