How To Use CPT Code 33660

CPT 33660 describes the repair of an incomplete or partial atrioventricular canal, also known as an ostium primum atrial septal defect. 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 33660?

CPT 33660 can be used to describe the repair of an incomplete or partial atrioventricular canal, specifically an ostium primum atrial septal defect. This procedure involves closing a “hole” in the wall between the atria and ventricles using sutures or a patch made of Dacron® material or pericardium. Additionally, the tricuspid and mitral valves may be repaired if there is a valve defect. The goal is to ensure that the valve leaflets are properly placed and the septum is rebuilt to support the reconstructed valves.

2. Official Description

The official description of CPT code 33660 is: ‘Repair of incomplete or partial atrioventricular canal (ostium primum atrial septal defect), with or without atrioventricular valve repair.’

3. Procedure

1. Under general anesthesia, the provider makes an incision in the middle of the chest to expose the heart.
2. A heart-lung machine, also known as cardiopulmonary bypass (CPB), is used to maintain circulation and oxygenation while the heart is cooled, stopped, emptied, and opened.
3. The anterior leaflet of the mitral valve is closed with interrupted sutures, and the valve is secured with adequate sutures.
4. The ventricular septal defect is closed by sewing a patch of Dacron® cloth or pericardium to it.
5. The atrial septal defect is also closed using a patch of Dacron® or pericardium.
6. If necessary, the tricuspid and mitral valves are reconstructed based on the severity of the defect and supported by the rebuilt septum.
7. The heart is closed, restarted, and the heart-lung machine is removed.

4. Qualifying circumstances

CPT 33660 is performed on patients with an incomplete or partial atrioventricular canal, specifically an ostium primum atrial septal defect. This defect involves a large hole in the center of the heart where the wall between the two atria joins the wall between the two ventricles. The procedure may also involve repairing the tricuspid and mitral valves if there is a valve defect. The use of a heart-lung machine (CPB) is necessary to maintain circulation and oxygenation during the procedure.

5. When to use CPT code 33660

CPT code 33660 should be used when performing the repair of an incomplete or partial atrioventricular canal, specifically an ostium primum atrial septal defect. It is important to ensure that the procedure includes the closure of the ventricular and atrial septal defects, as well as any necessary repair of the tricuspid and mitral valves. This code should not be used for other types of atrial septal defects or procedures that do not involve the repair of an incomplete or partial atrioventricular canal.

6. Documentation requirements

To support a claim for CPT 33660, the provider must document the following information:

• Patient’s diagnosis of an incomplete or partial atrioventricular canal
• Description of the repair procedure performed, including closure of the ventricular and atrial septal defects and any valve repair
• Date of the procedure
• Details of the use of a heart-lung machine (CPB)
• Any additional relevant information or complications encountered during the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 33660, ensure that the procedure performed is the repair of an incomplete or partial atrioventricular canal, specifically an ostium primum atrial septal defect. It is important to include the closure of the ventricular and atrial septal defects, as well as any necessary repair of the tricuspid and mitral valves. There are no specific guidelines regarding reporting CPT 33660 with other codes. However, it is important to accurately document and code all procedures performed during the surgery.

8. Historical information

CPT 33660 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 reimbursement purposes.

9. Examples

1. A provider performs a repair of an incomplete atrioventricular canal, closing the ventricular and atrial septal defects, and repairing the tricuspid and mitral valves.
2. During a surgical procedure, a provider repairs a partial atrioventricular canal, closing the ventricular and atrial septal defects, and reconstructing the tricuspid and mitral valves.
3. A patient undergoes a repair of an ostium primum atrial septal defect, with closure of the ventricular and atrial septal defects, and repair of the tricuspid and mitral valves.