How To Use CPT Code 33641

CPT 33641 describes the surgical procedure for repairing an atrial septal defect, specifically a secundum defect, with or without the use of a patch. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 33641?

CPT 33641 is used to describe the surgical closure of an atrial septal defect, specifically a secundum defect, with or without the use of a patch. This procedure involves opening up the atrium and closing the defect under direct visualization. The provider performs this surgery while the patient is under general anesthesia and using cardiopulmonary bypass.

2. Official Description

The official description of CPT code 33641 is: ‘Repair atrial septal defect, secundum, with cardiopulmonary bypass, with or without patch.’

3. Procedure

1. The provider prepares the patient and administers general anesthesia.
2. The pericardium is opened, and the patient is placed on cardiopulmonary bypass.
3. Cardioplegia is administered to induce cardiac arrest.
4. The right atrium is opened to access the atrial septum.
5. The defect is closed using sutures or a patch made of the patient’s own pericardium, bovine pericardium, or synthetic material.
6. The atrial incision is closed, and the aortic cross-clamp is removed.
7. The patient is weaned off cardiopulmonary bypass, and a drainage tube is placed.
8. The chest is closed, and the procedure is completed.

4. Qualifying circumstances

CPT 33641 is performed on patients with an atrial septal defect, specifically a secundum defect. This congenital defect causes a hole between the upper heart chambers, allowing blood flow between the left and right atria. The procedure is performed by a provider who opens the atrium, closes the defect, and uses cardiopulmonary bypass. The use of a patch may be necessary depending on the size of the defect.

5. When to use CPT code 33641

CPT code 33641 should be used when a provider performs surgical closure of an atrial septal defect, specifically a secundum defect, using cardiopulmonary bypass. This code covers the procedure with or without the use of a patch. It is important to review the documentation and choose the correct code from the range of codes 33641 through 33697 based on the specific procedure performed.

6. Documentation requirements

To support a claim for CPT 33641, the provider must document the following information:

• Patient’s diagnosis of an atrial septal defect, specifically a secundum defect
• Details of the procedure performed, including the use of cardiopulmonary bypass and whether a patch was used
• Date of the procedure
• Any additional relevant information or complications encountered during the procedure
• Signature of the performing provider

7. Billing guidelines

When billing for CPT 33641, ensure that the procedure meets the criteria outlined in the official description. It is important to accurately document the use of cardiopulmonary bypass and the use of a patch, if applicable. Review the documentation to determine the correct code within the range of codes 33641 through 33697. It is also important to follow any specific billing guidelines provided by the payer or coding guidelines.

8. Historical information

CPT 33641 was added to the Current Procedural Terminology system on January 1, 1990. The code has not undergone any updates since its addition. In 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A provider performs surgical closure of an atrial septal defect using cardiopulmonary bypass and a patch.
2. A patient with an atrial septal defect undergoes a procedure to close the defect without the use of a patch.
3. A provider repairs an atrial septal defect, specifically a secundum defect, using cardiopulmonary bypass and a synthetic patch.
4. A patient with an atrial septal defect undergoes a procedure to close the defect with direct sutures.
5. A provider performs surgical closure of an atrial septal defect using cardiopulmonary bypass and the patient’s own pericardium as a patch.
6. A patient with an atrial septal defect undergoes a procedure to close the defect with a bovine pericardium patch.
7. A provider repairs an atrial septal defect, specifically a secundum defect, using cardiopulmonary bypass and a pericardial patch.
8. A patient with an atrial septal defect undergoes a procedure to close the defect with a synthetic patch.
9. A provider performs surgical closure of an atrial septal defect using cardiopulmonary bypass and a patch, with additional complications encountered during the procedure.
10. A patient with an atrial septal defect undergoes a procedure to close the defect without the use of a patch, with a successful outcome.