How To Use CPT Code 33620

CPT 33620 describes the application of pulmonary artery bands to reduce blood flow and relieve congestive heart failure and pulmonary hypertension. 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 33620?

CPT 33620 can be used to describe the surgical procedure in which a provider places bands around both the right and left pulmonary arteries. This procedure is performed to reduce left to right blood flow and alleviate congestive heart failure and pulmonary hypertension. It is typically part of other staged procedures to correct or modify multiple congenital cardiac anomalies.

2. Official Description

The official description of CPT code 33620 is the application of right and left pulmonary artery bands to restrict pulmonary blood flow and prevent enlargement of the ventricle and elevated blood pressure in the pulmonary artery. This procedure is typically performed through a sternotomy or lateral thoracotomy approach and is part of the repair procedures for single ventricle and other complex cardiac anomalies.

3. Procedure

1. When the patient is appropriately prepped and anesthetized, the provider makes an incision in the chest, typically a left anterior thoracotomy or a left lateral thoracotomy, sparing the sternum for subsequent procedures.
2. The provider exposes the main pulmonary artery (MPA) and aorta and prepares the bands for placement.
3. The provider dissects the tissue connecting the aorta and main pulmonary artery and passes the band through the transverse sinus to surround both the aorta and MPA.
4. The provider carefully advances the aortic end of the band through the previous site of dissection and places it between the aorta and the MPA.
5. The provider places both left and right pulmonary artery bands.
6. The provider closes the incisions in the heart, checks for bleeding, removes any instruments, and finally closes the incision in the chest.

4. Qualifying circumstances

CPT 33620 is performed on patients with congenital heart defects that require the restriction of pulmonary blood flow. The procedure is typically part of staged procedures to correct or modify multiple cardiac anomalies. It is important to note that this code should not be used for banding of the main pulmonary artery related to septal defects, which should be coded as 33690.

5. When to use CPT code 33620

CPT code 33620 should be used when a provider applies pulmonary artery bands to restrict blood flow and alleviate congestive heart failure and pulmonary hypertension. It is important to ensure that the procedure is part of staged procedures for complex cardiac anomalies and not for other conditions or situations.

6. Documentation requirements

To support a claim for CPT 33620, the provider must document the following information:

• Patient’s diagnosis and the need for pulmonary artery banding
• Approach used for the procedure (sternotomy or lateral thoracotomy)
• Details of the procedure, including the placement of bands around the right and left pulmonary arteries
• Any additional procedures performed during the same session
• Any complications or unexpected findings
• Signature of the performing provider

7. Billing guidelines

When billing for CPT 33620, ensure that the procedure is performed as part of staged procedures for complex cardiac anomalies. It is important to use the appropriate approach code (sternotomy or lateral thoracotomy) and to provide the necessary documentation to support the claim. It is also important to follow any specific billing guidelines provided by the payer or Medicare.

8. Historical information

CPT 33620 was added to the Current Procedural Terminology system on January 1, 2011. In 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A provider applies pulmonary artery bands to restrict blood flow and alleviate congestive heart failure and pulmonary hypertension in a patient with complex cardiac anomalies.
2. During a staged procedure, a provider places bands around the right and left pulmonary arteries to reduce blood flow and prevent enlargement of the ventricle in a patient with a single ventricle defect.
3. A patient with multiple congenital cardiac anomalies undergoes a procedure in which pulmonary artery bands are applied to restrict blood flow and relieve pulmonary hypertension.
4. As part of a hybrid approach, two providers perform a procedure together to repair complex cardiac anomalies in an infant, including the application of pulmonary artery bands.
5. A provider performs a lateral thoracotomy and applies pulmonary artery bands to restrict blood flow and alleviate congestive heart failure and pulmonary hypertension in a patient with complex cardiac anomalies.
6. During a staged procedure, a provider places bands around the right and left pulmonary arteries to reduce blood flow and prevent enlargement of the ventricle in a patient with multiple congenital cardiac anomalies.
7. A patient with a single ventricle defect undergoes a procedure in which pulmonary artery bands are applied to restrict blood flow and relieve pulmonary hypertension.
8. As part of a hybrid approach, two providers perform a procedure together to repair complex cardiac anomalies in an infant, including the application of pulmonary artery bands.
9. A provider performs a sternotomy and applies pulmonary artery bands to restrict blood flow and alleviate congestive heart failure and pulmonary hypertension in a patient with complex cardiac anomalies.
10. During a staged procedure, a provider places bands around the right and left pulmonary arteries to reduce blood flow and prevent enlargement of the ventricle in a patient with multiple congenital cardiac anomalies.