How To Use CPT Code 33510

CPT 33510 describes the procedure of coronary artery bypass using a single venous graft. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 33510?

CPT 33510 can be used to describe the surgical procedure in which a qualified healthcare provider diverts blood flow from a damaged vessel in the heart by grafting in a segment of a vein taken from another location, such as the leg. This procedure aims to restore circulation, improve the function of the heart, and alleviate symptoms like angina.

2. Official Description

The official description of CPT code 33510 is: ‘Coronary artery bypass, vein only; single coronary venous graft.’

3. Procedure

1. The healthcare provider prepares the patient for the procedure, ensuring appropriate prepping and anesthesia.
2. The provider harvests a single vein suitable for coronary artery bypass grafting, typically from the saphenous vein in the leg.
3. A midline sternotomy is performed, which involves making an incision through the breastbone.
4. Aortic and venous cannulas are inserted to establish cardiopulmonary bypass, or machine circulation.
5. A cardioplegia solution is injected to stop the heart temporarily for the procedure.
6. The distal end of the prepared saphenous vein is attached to an appropriate place on the side of the diseased vessel, and the proximal end of the graft is attached to a hole punched into the ascending aorta.
7. The patient is weaned off the bypass pump, and the heart resumes its normal function.
8. The provider irrigates the area, checks for bleeding, removes any instruments, and closes the incision in layers.

4. Qualifying circumstances

Patients who may require CPT 33510 are those with obstructed main arteries of the heart that necessitate coronary artery bypass grafting. The procedure involves the use of a single venous graft, typically harvested from the saphenous vein in the leg. The patient must have symptoms such as angina pectoris, which is severe chest pain due to insufficient blood supply within the heart.

5. When to use CPT code 33510

CPT code 33510 should be used when a qualified healthcare provider performs a coronary artery bypass using a single venous graft. It is important to note that this code is specifically for cases where only vein grafts are used. If arterial graft anastomosis is also performed, a different code should be selected.

6. Documentation requirements

To support a claim for CPT 33510, the healthcare provider must document the following information:

• Number and type of grafts completed during the procedure
• Details of the harvested vein, such as the location and suitability for grafting
• Description of the surgical approach, including the midline sternotomy
• Use of cardiopulmonary bypass and cardioplegia solution
• Specific vessels involved in the grafting procedure
• Confirmation of successful weaning off the bypass pump
• Any complications or additional procedures performed

7. Billing guidelines

When billing for CPT 33510, ensure that the procedure involves the use of a single venous graft and that the documentation supports this. It is important to accurately report the number and type of grafts completed during the procedure. If arterial graft anastomosis is also performed, a different code should be selected. Review the specific guidelines provided by the payer to ensure accurate billing.

8. Historical information

CPT 33510 was added to the Current Procedural Terminology system on January 1, 1990. In 2017, it was added under the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A qualified healthcare provider performs a coronary artery bypass using a single venous graft to restore blood flow in a patient with severe angina.
2. During the procedure, the provider harvests a suitable vein from the patient’s leg and attaches it to the diseased vessel and the ascending aorta.
3. The patient’s symptoms improve, and the procedure is successful in restoring circulation and improving heart function.
4. Another patient undergoes a similar procedure, but with the use of multiple venous grafts for more complex coronary artery bypass.
5. The provider carefully selects and attaches the grafts to the appropriate vessels, ensuring optimal blood flow and improved heart function.
6. In both cases, the documentation accurately reflects the number and type of grafts used, as well as the success of the procedure.
7. These examples demonstrate the appropriate usage of CPT code 33510 for coronary artery bypass using a single venous graft.
8. It is important for healthcare providers to document the details of the procedure and the patient’s condition to support accurate billing and reimbursement.
9. By following the documentation requirements and billing guidelines, providers can ensure proper coding and billing for CPT 33510.
10. These examples highlight the importance of accurate documentation and coding for coronary artery bypass procedures.