How To Use CPT Code 33521

CPT 33521 describes the procedure of coronary artery bypass using four venous grafts and arterial grafts. 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 33521?

CPT 33521 is used to describe a specific surgical procedure known as coronary artery bypass grafting (CABG). This procedure involves diverting blood flow from damaged vessels in the heart by grafting four vein segments taken from another location, such as the leg. The purpose of this procedure is to restore circulation, improve heart function, and alleviate symptoms like angina.

2. Official Description

The official description of CPT code 33521 is: ‘Coronary artery bypass, using venous graft(s) and arterial graft(s); 4 venous grafts (List separately in addition to code for primary procedure).’ This code should be used in conjunction with other codes related to coronary artery bypass grafting.

3. Procedure

1. The provider begins by preparing the patient for the coronary artery bypass grafting procedure, ensuring they are appropriately prepped and anesthetized.
2. During the procedure, the provider harvests four vein segments, typically from the saphenous vein in the leg, which will be used as grafts.
3. The provider then attaches the distal end of the prepared saphenous veins to appropriate locations on the side of the diseased target vessels.
4. The proximal ends of the grafts are then attached to holes punched in the aorta.
5. The provider continues with the primary procedure, which may involve additional arterial grafting, reversing cardioplegia, and weaning the patient from cardiopulmonary bypass.
6. After completing the primary procedure, the provider irrigates the area, checks for bleeding, removes any instruments, and closes the incision.

4. Qualifying circumstances

CPT 33521 is used for patients who require coronary artery bypass grafting using four venous grafts and arterial grafts. This procedure is typically performed on patients with obstructed main arteries of the heart, resulting in insufficient blood supply and symptoms such as angina. The patient must meet the criteria for coronary artery bypass grafting, and the provider must determine that the use of four venous grafts and arterial grafts is necessary for the procedure.

5. When to use CPT code 33521

CPT code 33521 should be used when the provider performs a coronary artery bypass grafting procedure using four venous grafts and arterial grafts. It is important to note that this code should be used in addition to the primary procedure code for coronary artery bypass grafting.

6. Documentation requirements

To support a claim for CPT 33521, the provider must document the following information:

• Indication for the coronary artery bypass grafting procedure
• Details of the grafts used, including the number of venous grafts and arterial grafts
• Specific locations where the grafts were attached
• Any additional procedures performed during the primary procedure
• Confirmation of completion of the primary procedure, including irrigation, hemostasis, and closure

7. Billing guidelines

When billing for CPT 33521, ensure that the procedure meets the criteria for coronary artery bypass grafting using four venous grafts and arterial grafts. It is important to report this code in addition to the primary procedure code for coronary artery bypass grafting. Pay attention to any specific guidelines provided by payers regarding the use of this code and any modifiers that may be required.

8. Historical information

CPT 33521 was added to the Current Procedural Terminology system on January 1, 1993. There have been some changes to the code over the years, including updates to the description and the addition of notes. It is important to stay updated with any changes or revisions to ensure accurate coding.

9. Examples

1. A patient undergoes coronary artery bypass grafting using four venous grafts and arterial grafts to restore blood flow and improve heart function.
2. A provider performs a coronary artery bypass grafting procedure using four venous grafts and arterial grafts on a patient with severe angina.
3. During a coronary artery bypass grafting procedure, the provider utilizes four venous grafts and arterial grafts to bypass obstructed main arteries of the heart.
4. A patient with multiple blocked arteries undergoes coronary artery bypass grafting using four venous grafts and arterial grafts to improve blood flow and alleviate symptoms.
5. A provider performs a complex coronary artery bypass grafting procedure using four venous grafts and arterial grafts to address multiple areas of blockage in the patient’s heart.
6. During a coronary artery bypass grafting procedure, the provider utilizes four venous grafts and arterial grafts to restore circulation and improve heart function in a patient with significant coronary artery disease.
7. A patient with a history of heart disease undergoes coronary artery bypass grafting using four venous grafts and arterial grafts to improve blood flow and reduce the risk of future cardiac events.
8. A provider performs a successful coronary artery bypass grafting procedure using four venous grafts and arterial grafts to alleviate symptoms and improve the patient’s quality of life.
9. During a complex coronary artery bypass grafting procedure, the provider utilizes four venous grafts and arterial grafts to bypass multiple areas of blockage and restore blood flow to the heart.