How To Use CPT Code 33611

CPT 33611 describes the repair of double outlet right ventricle with intraventricular tunnel repair. 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 33611?

CPT 33611 can be used to describe the surgical procedure performed to repair a double outlet right ventricle with intraventricular tunnel repair. This code is used when the provider creates a tunnel graft using artificial graft material between the ventricular septal defect (VSD) and the aorta, redirecting blood flow into the aorta.

2. Official Description

The official description of CPT code 33611 is: ‘Repair of double outlet right ventricle with intraventricular tunnel repair.’

3. Procedure

1. The provider makes an incision in the chest to access the heart.
2. The patient is placed on cardiopulmonary bypass to temporarily take over the function of the heart and lungs.
3. The provider opens the right atrium and examines the ventricular septal defect (VSD) through the tricuspid valve.
4. If needed, the provider enlarges the VSD.
5. A patch graft, typically made of polytetrafluoroethylene (PTFE), is placed through the VSD to form a tunnel that corresponds to the diameter of the aorta.
6. The provider directs blood from the left ventricle to the aorta through the tunnel graft.
7. The patient is removed from cardiopulmonary bypass.
8. The provider closes the incisions in the heart, checks for bleeding, removes any instruments, and closes the incision in the chest.

4. Qualifying circumstances

CPT 33611 is performed on patients with a congenital condition called double outlet right ventricle (DORV) associated with a ventricular septal defect (VSD). The procedure is done to redirect blood flow from the left ventricle to the aorta using a tunnel graft. The patient must meet the specific criteria for this procedure, and the provider must document the medical necessity for performing the repair.

5. When to use CPT code 33611

CPT code 33611 should be used when the provider performs the repair of a double outlet right ventricle with intraventricular tunnel repair. It is important to ensure that the procedure meets the specific criteria outlined in the code description. If the procedure performed does not match the description of CPT 33611, a different code should be used.

6. Documentation requirements

To support a claim for CPT 33611, the provider must document the following information:

• Patient’s diagnosis of double outlet right ventricle with ventricular septal defect
• Description of the repair procedure performed, including the use of a tunnel graft and the specific materials used
• Date of the procedure
• Details of the surgical approach and any additional procedures performed
• Any complications or unexpected findings during the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 33611, ensure that the procedure performed matches the description of the code. It is important to follow the specific guidelines for reporting this code and any associated modifiers. Modifier 63 should not be reported in conjunction with CPT 33611. Additionally, be aware of any Medicare changes or specific billing requirements for this procedure.

8. Historical information

CPT 33611 was added to the Current Procedural Terminology system on January 1, 1994. There have been historical changes to the code, including a code change on January 1, 2010, and its addition to the Inpatient Only (IPO) list in 2017 for Medicare billing purposes.

9. Examples

1. A provider performs a repair of double outlet right ventricle with intraventricular tunnel repair on a patient with a congenital heart defect.
2. A patient with double outlet right ventricle and a ventricular septal defect undergoes a surgical procedure to redirect blood flow using a tunnel graft.
3. A provider performs an intraventricular tunnel repair on a patient with a double outlet right ventricle and a ventricular septal defect.
4. A surgical team performs a repair of double outlet right ventricle with intraventricular tunnel repair using polytetrafluoroethylene (PTFE) graft material.
5. A patient with a congenital heart anomaly undergoes a procedure to repair a double outlet right ventricle with intraventricular tunnel repair.
6. A provider performs a surgical repair on a patient with double outlet right ventricle and a ventricular septal defect, redirecting blood flow using a tunnel graft.
7. A patient with a congenital heart defect undergoes a repair of double outlet right ventricle with intraventricular tunnel repair to improve blood flow.
8. A surgical team performs an intraventricular tunnel repair on a patient with double outlet right ventricle and a ventricular septal defect, using a patch graft made of polytetrafluoroethylene (PTFE).
9. A provider performs a repair procedure on a patient with a double outlet right ventricle and a ventricular septal defect, creating a tunnel graft to redirect blood flow.
10. A patient with a congenital heart anomaly undergoes a surgical repair of double outlet right ventricle with intraventricular tunnel repair to improve cardiac function.