How To Use CPT Code 33665

CPT 33665 describes the repair of an intermediate or transitional atrioventricular canal, with or without atrioventricular valve 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 33665?

CPT 33665 can be used to describe the repair of an intermediate or transitional atrioventricular canal, with or without atrioventricular valve repair. This code is used when a healthcare professional closes the hole in the cardiac septa that causes mixing of blood inside the heart chambers and restores valve competence. The severity of the defect determines whether the valve is repaired with sutures or replaced with a mechanical or tissue valve.

2. Official Description

The official description of CPT code 33665 is: ‘Repair of intermediate or transitional atrioventricular canal, with or without atrioventricular valve repair.’

3. Procedure

1. The healthcare professional makes an incision through the middle of the chest to expose the heart.
2. Cardiopulmonary bypass is initiated, and the right atrium is emptied.
3. A hole is made in the right atrium or one of the ventricles, depending on the location of the defect.
4. The healthcare professional repairs the atrioventricular valves using sutures or patches of Dacron or pericardium to restore valve competence.
5. If valve competence cannot be achieved, the healthcare professional replaces the valve with a mechanical or tissue valve.
6. The heart is closed, and the patient is taken off the heart-lung machine.

4. Qualifying circumstances

Patients eligible for CPT 33665 are those with an intermediate or transitional atrioventricular canal defect, where the wall between the two atria joins the wall between the two ventricles. The atrioventricular valves may only be partially separated into two valves. The procedure is performed under general anesthesia, and the patient must be on cardiopulmonary bypass. The healthcare professional must assess the severity of the defect and determine the appropriate repair method.

5. When to use CPT code 33665

CPT code 33665 should be used when a healthcare professional performs the repair of an intermediate or transitional atrioventricular canal, with or without atrioventricular valve repair. This code should be used for each instance of the procedure performed. It is important to note that CPT code 33665 is an inpatient-only procedure.

6. Documentation requirements

To support a claim for CPT 33665, the healthcare professional must document the following information:

• Patient’s diagnosis of an intermediate or transitional atrioventricular canal defect
• Details of the repair procedure performed, including whether atrioventricular valve repair was included
• Date of the procedure
• Start and end time of the procedure
• Any additional details or complications encountered during the procedure
• Signature of the healthcare professional performing the procedure

7. Billing guidelines

When billing for CPT 33665, ensure that the procedure meets the criteria for an intermediate or transitional atrioventricular canal defect repair. Use the appropriate CPT code based on the specific repair performed. It is important to note that CPT code 33665 is an inpatient-only procedure and should not be reported for outpatient services. Additionally, consider any applicable modifiers or additional codes that may be necessary to accurately report the procedure.

8. Historical information

CPT 33665 was added to the Current Procedural Terminology system on January 1, 1990. The code was later added to the Inpatient Only (IPO) list for Medicare in 2017.

9. Examples

1. A healthcare professional performs a repair of an intermediate atrioventricular canal, with atrioventricular valve repair, on a patient with a congenital heart defect.
2. A surgeon closes the hole in the cardiac septa and restores atrioventricular valve competence in a patient with a transitional atrioventricular canal defect.
3. A cardiac specialist replaces the atrioventricular valve with a mechanical valve during the repair of an intermediate atrioventricular canal.
4. A healthcare team repairs an intermediate atrioventricular canal, without atrioventricular valve repair, in a patient with a congenital heart defect.
5. A surgeon performs a repair of a transitional atrioventricular canal, with atrioventricular valve repair, on a patient with a complex heart condition.
6. A cardiac specialist replaces the atrioventricular valve with a tissue valve during the repair of a transitional atrioventricular canal.
7. A healthcare professional repairs an intermediate atrioventricular canal, without atrioventricular valve repair, in a patient with a history of heart disease.
8. A surgeon closes the hole in the cardiac septa and restores atrioventricular valve competence in a patient with a transitional atrioventricular canal defect.
9. A cardiac specialist replaces the atrioventricular valve with a mechanical valve during the repair of an intermediate atrioventricular canal.
10. A healthcare team repairs a transitional atrioventricular canal, with atrioventricular valve repair, in a patient with a complex heart condition.