How To Use CPT Code 33622

CPT 33622 describes the reconstruction of a complex cardiac anomaly, specifically for patients with a single ventricle or hypoplastic left heart. 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 33622?

CPT 33622 is a code used to describe a complex cardiac reconstruction procedure. It is specifically used for patients with a single ventricle or hypoplastic left heart. The procedure aims to improve blood flow in and out of the heart, preventing complications such as congestive heart failure and pulmonary hypertension.

2. Official Description

The official description of CPT code 33622 is the reconstruction of a complex cardiac anomaly, including the palliation of a single ventricle with aortic outflow obstruction and aortic arch hypoplasia. The procedure involves creating a cavopulmonary anastomosis, removing right and left pulmonary bands, and utilizing a hybrid approach stage 2, Norwood, bidirectional Glenn, or pulmonary artery debanding. It is important to note that CPT 33622 should not be reported in conjunction with certain other codes, as specified in the notes.

3. Procedure

1. The provider begins by making an incision in the chest, typically a median sternotomy, after the patient is appropriately prepped and anesthetized.
2. Cardiopulmonary bypass (CPB) is initiated, temporarily taking over the function of the heart and lungs to maintain blood circulation and oxygenation during the surgery.
3. The provider performs various steps, including an atrial septectomy, division of the ductus and main pulmonary trunk, closure of the pulmonary artery with a patch, removal of remaining ductal tissue, and enlargement of the aorta with a patch.
4. The provider examines the bands around the right and left pulmonary arteries, assessing the main pulmonary artery and its branches. Depending on the severity of stenosis, the provider may enlarge the area with a bovine pericardial patch graft or perform an end-to-end anastomosis of the pulmonary artery.
5. The provider closes the incisions in the heart, checks for bleeding, removes any instruments, and takes the patient off CPB.
6. Finally, the provider closes the incision in the chest.

4. Qualifying circumstances

CPT 33622 is performed on patients with complex cardiac anomalies, specifically those with a single ventricle or hypoplastic left heart. These conditions result in underdevelopment or obstruction of blood flow, requiring surgical intervention. The procedure is typically performed by cardiac specialists and may involve a hybrid approach in challenging cases. It is important to note that CPT 33622 should not be reported with certain other codes, as specified in the notes.

5. When to use CPT code 33622

CPT code 33622 should be used when performing a complex cardiac reconstruction procedure for patients with a single ventricle or hypoplastic left heart. It is important to ensure that the patient meets the qualifying circumstances for this code and that the procedure is necessary to improve blood flow and prevent complications. CPT 33622 should not be used in conjunction with certain other codes, as specified in the notes.

6. Documentation requirements

To support a claim for CPT 33622, the provider must document the following information:

• Patient’s diagnosis and the need for complex cardiac reconstruction
• Specific details of the procedure performed, including the use of a hybrid approach if applicable
• Date of the procedure
• Any additional relevant information, such as complications or unique aspects of the case
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 33622, it is important to ensure that the procedure meets the qualifying circumstances and is appropriately documented. The provider should not report CPT 33622 in conjunction with certain other codes, as specified in the notes. It is also important to follow any specific billing guidelines provided by the payer or relevant coding guidelines.

8. Historical information

CPT 33622 was added to the Current Procedural Terminology system on January 1, 2011. It has not undergone any updates since its addition. Additionally, it is important to note that CPT 33622 was added to the Inpatient Only (IPO) list for Medicare in 2017, indicating that it is typically performed in an inpatient setting.

9. Examples

1. A patient with a single ventricle undergoes a complex cardiac reconstruction procedure to improve blood flow and prevent complications.
2. A newborn with hypoplastic left heart syndrome requires surgical intervention, including the creation of a cavopulmonary anastomosis and removal of pulmonary bands.
3. A child with aortic arch hypoplasia undergoes a hybrid approach stage 2 procedure to address the complex cardiac anomaly.
4. A patient with a single ventricle and aortic outflow obstruction undergoes a Norwood procedure to improve blood flow and prevent further complications.
5. An infant with a complex cardiac anomaly undergoes a bidirectional Glenn procedure to improve blood flow and alleviate symptoms.
6. A patient with a single ventricle and pulmonary artery debanding undergoes a surgical procedure to remove the pulmonary bands and improve blood flow.
7. A child with aortic arch hypoplasia and a complex cardiac anomaly undergoes a hybrid approach procedure to address the specific anatomical challenges.
8. A newborn with a single ventricle and aortic outflow obstruction undergoes a complex cardiac reconstruction procedure to improve blood flow and prevent complications.