How To Use CPT Code 33508

CPT 33508 describes the use of surgical endoscopy to visualize structures surrounding the vein harvested for a coronary artery bypass procedure. 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 33508?

CPT 33508 can be used to describe the utilization of surgical endoscopy to visualize the surrounding structures of the vein that is harvested for a coronary artery bypass procedure. This code is used when the physician employs endoscopy to ensure a clear view of the vein and its surrounding tissues during the harvesting process.

2. Official Description

The official description of CPT code 33508 is: ‘Endoscopy, surgical, including video-assisted harvest of vein(s) for coronary artery bypass procedure (List separately in addition to code for primary procedure).’ This code should be used in conjunction with other codes related to the primary procedure, such as 33510-33523. For open harvest of the upper extremity vein, code 35500 should be used instead.

3. Procedure

1. The physician makes a small incision at the harvest site to access the vein.
2. Endoscopy is used to visualize the vein and its surrounding tissues.
3. The surrounding tissues are separated from the vein through insufflation using a balloon trocar.
4. The desired length of the vein is dissected and removed after ligating the tributaries of the vessel and applying clips to the proximal and distal ends of the vein part to be dissected.
5. The endoscope is removed, and the wound is closed after applying antibiotics.

4. Qualifying circumstances

CPT 33508 is used when a coronary artery bypass graft is performed on a patient with coronary artery disease (CAD). The procedure involves replacing the atherosclerotic coronary artery with a healthy vascular graft collected from another part of the body, commonly the saphenous vein in the leg. The endoscopy is necessary to visualize the vein and its surrounding tissues during the harvesting process.

5. When to use CPT code 33508

CPT code 33508 should be used when the physician utilizes surgical endoscopy to visualize the structures surrounding the vein that is being harvested for a coronary artery bypass procedure. It is important to note that this code should only be reported when used in conjunction with the primary procedure code. Additionally, it should not be reported separately for open harvest of the upper extremity vein, as code 35500 should be used in that case.

6. Documentation requirements

To support a claim for CPT 33508, the physician must document the following information:

• Indication for the coronary artery bypass procedure
• Specific details of the endoscopic visualization of the vein and surrounding structures
• Length of the vein dissected and removed
• Details of ligating the tributaries and applying clips to the proximal and distal ends of the vein
• Use of antibiotics and wound closure

7. Billing guidelines

When billing for CPT 33508, it is important to ensure that the procedure meets the criteria for utilizing surgical endoscopy. This code should be reported in addition to the primary procedure code and should not be reported separately for open harvest of the upper extremity vein. It is also essential to follow any specific guidelines provided by the payer regarding the use of endoscopy and reporting of multiple procedures.

8. Historical information

CPT 33508 was added to the Current Procedural Terminology system on January 1, 2003. There have been no updates or changes to the code since its addition.

9. Examples

1. A physician utilizing surgical endoscopy to visualize the structures surrounding the vein harvested for a single coronary artery bypass graft.
2. A surgeon employing endoscopy to ensure a clear view of the vein and its surrounding tissues during the harvesting process for two coronary artery bypass grafts.
3. A cardiovascular specialist using endoscopy to visualize the structures surrounding the vein harvested for three coronary artery bypass grafts.
4. A cardiac surgeon performing endoscopy to ensure proper visualization of the structures surrounding the vein harvested for four or more coronary artery bypass grafts.
5. A physician utilizing surgical endoscopy to visualize the structures surrounding the vein harvested for a coronary artery bypass procedure, along with additional procedures performed during the same surgery.
6. A surgeon employing endoscopy to ensure a clear view of the vein and its surrounding tissues during the harvesting process for a coronary artery bypass procedure, with the addition of other cardiac procedures.
7. A cardiovascular specialist using endoscopy to visualize the structures surrounding the vein harvested for a coronary artery bypass procedure, along with other interventions performed during the same surgery.
8. A cardiac surgeon performing endoscopy to ensure proper visualization of the structures surrounding the vein harvested for a coronary artery bypass procedure, with the addition of multiple other cardiac procedures.
9. A physician utilizing surgical endoscopy to visualize the structures surrounding the vein harvested for a coronary artery bypass procedure, along with other cardiac interventions performed during the same surgery.
10. A surgeon employing endoscopy to ensure a clear view of the vein and its surrounding tissues during the harvesting process for a coronary artery bypass procedure, with the addition of various other cardiac procedures.