How To Use CPT Code 33522

CPT 33522 describes the procedure for coronary artery bypass using venous grafts and arterial grafts, specifically involving five venous grafts. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 33522?

CPT 33522 can be used to describe the procedure of coronary artery bypass grafting using both venous and arterial grafts, with a specific focus on utilizing five venous grafts. This code is used when the provider diverts blood flow from damaged vessels in the heart by grafting five vein segments taken from another location, such as the leg, to restore circulation, improve heart function, and alleviate symptoms like angina.

2. Official Description

The official description of CPT code 33522 is: ‘Coronary artery bypass, using venous graft(s) and arterial graft(s); 5 venous grafts (List separately in addition to code for primary procedure).’ This code should be used in conjunction with other codes for primary procedures, such as 33533 – 33536.

3. Procedure

1. The provider begins by preparing the patient and administering anesthesia.
2. During the coronary artery bypass grafting procedure, the provider harvests five vein segments, typically from the saphenous vein in the leg, suitable for grafting.
3. The provider attaches the distal end of the prepared saphenous veins to appropriate locations on the side of the diseased target vessels and the proximal ends to holes punched in the aorta.
4. The provider then continues with the primary procedure, completing the arterial grafting, reversing cardioplegia, and weaning the patient from cardiopulmonary bypass.
5. After completing the primary procedure, the provider irrigates the area, checks for bleeding, removes any instruments, and closes the incision.

4. Qualifying circumstances

Patients eligible for CPT 33522 are those who require coronary artery bypass grafting and have suitable vein segments available for grafting. The procedure is typically performed to restore blood flow to the heart, improve heart function, and alleviate symptoms like angina. The provider must utilize five venous grafts and may also perform arterial grafting as part of the procedure.

5. When to use CPT code 33522

CPT code 33522 should be used when the provider performs coronary artery bypass grafting using five venous grafts and arterial grafts as part of the procedure. This code should be used in conjunction with other codes for primary procedures, such as 33533 – 33536.

6. Documentation requirements

To support a claim for CPT 33522, the provider must document the following information:

• Indication for coronary artery bypass grafting
• Number and type of grafts used (specifically five venous grafts)
• Details of the procedure, including the harvesting and attachment of grafts
• Completion of the primary procedure, including arterial grafting
• Confirmation of reversal of cardioplegia and weaning from cardiopulmonary bypass
• Irrigation, hemostasis, removal of instruments, and closure of the incision

7. Billing guidelines

When billing for CPT 33522, ensure that the procedure involves the use of five venous grafts and arterial grafts. This code should be reported in addition to the primary procedure code. It is important to note that CPT 33522 is an inpatient-only (IPO) procedure, meaning it is typically performed in a hospital setting and not in an outpatient or office setting.

8. Historical information

CPT 33522 was added to the Current Procedural Terminology system on January 1, 1993. There have been several historical changes to the code, including updates to the description and the addition of the code to the Inpatient Only (IPO) list in 2017.

9. Examples

1. A provider performs coronary artery bypass grafting using five venous grafts and arterial grafts to restore blood flow and improve heart function in a patient with severe coronary artery disease.
2. During a coronary artery bypass grafting procedure, a provider utilizes five venous grafts and arterial grafts to alleviate angina symptoms and improve circulation in a patient with multiple blocked coronary arteries.
3. A patient undergoes coronary artery bypass grafting with five venous grafts and arterial grafts to address severe ischemic heart disease and improve overall heart function.
4. A provider performs coronary artery bypass grafting using five venous grafts and arterial grafts to restore blood flow and alleviate symptoms in a patient with significant coronary artery blockages.
5. During a coronary artery bypass grafting procedure, a provider utilizes five venous grafts and arterial grafts to improve heart function and alleviate angina symptoms in a patient with complex coronary artery disease.
6. A patient undergoes coronary artery bypass grafting with five venous grafts and arterial grafts to address severe coronary artery blockages and improve overall heart function.
7. A provider performs coronary artery bypass grafting using five venous grafts and arterial grafts to restore blood flow and alleviate symptoms in a patient with advanced coronary artery disease.
8. During a coronary artery bypass grafting procedure, a provider utilizes five venous grafts and arterial grafts to improve heart function and alleviate angina symptoms in a patient with multiple blocked coronary arteries.
9. A patient undergoes coronary artery bypass grafting with five venous grafts and arterial grafts to address severe ischemic heart disease and improve overall heart function.
10. A provider performs coronary artery bypass grafting using five venous grafts and arterial grafts to restore blood flow and alleviate symptoms in a patient with significant coronary artery blockages.