How To Use CPT Code 33677

CPT 33677 describes the closure of multiple ventricular septal defects, along with the removal of a pulmonary artery band, with or without a gusset. 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 33677?

CPT 33677 can be used to describe the surgical procedure performed to close multiple ventricular septal defects in the heart. The procedure also involves the removal of a previously placed pulmonary artery band, and may include the use of a gusset for reinforcement. This code is used when the provider performs these specific steps during the surgery.

2. Official Description

The official description of CPT code 33677 is: ‘Closure of multiple ventricular septal defects; with removal of pulmonary artery band, with or without gusset.’

3. Procedure

1. The provider makes an incision in the chest to access the heart.
2. The patient is placed on cardiopulmonary bypass (CPB) to temporarily take over the function of the heart and lungs.
3. The provider opens the right atrium and examines the ventricular septal defects.
4. Each ventricular septal defect is closed using sutures or patch grafts.
5. If necessary, a separate incision may be made to locate additional defects.
6. The provider removes the pulmonary artery band and repairs any associated defects.
7. The ends of the pulmonary artery are connected or reconstructed using a gusset or patch.
8. The incisions in the heart are closed, the patient is taken off CPB, and the chest incision is closed.

4. Qualifying circumstances

CPT 33677 is performed on patients with multiple ventricular septal defects that require closure. The procedure is typically done to prevent the mixing of oxygenated and deoxygenated blood in the ventricles. The patient may also have a previously placed pulmonary artery band that needs to be removed. The use of a gusset for reinforcement may be necessary in some cases. It is important to note that CPT 33677 should not be reported in conjunction with certain other codes, as specified in the notes.

5. When to use CPT code 33677

CPT code 33677 should be used when the provider performs the closure of multiple ventricular septal defects, along with the removal of a pulmonary artery band, with or without a gusset. It is important to ensure that the procedure meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT 33677, the provider must document the following information:

• Indication for the closure of multiple ventricular septal defects
• Details of the procedure, including the use of a pulmonary artery band and gusset, if applicable
• Date of the surgery
• Incision site and approach
• Specific steps taken during the procedure, such as closure of each ventricular septal defect and removal of the pulmonary artery band
• Any complications or additional procedures performed
• Signature of the provider

7. Billing guidelines

When billing for CPT 33677, ensure that the procedure meets the specific criteria outlined in the code description. It is important to note that CPT 33677 should not be reported in conjunction with certain other codes, as specified in the notes. Pay attention to any additional guidelines provided by payers or coding guidelines.

8. Historical information

CPT 33677 was added to the Current Procedural Terminology system on January 1, 2007. It 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 the closure of multiple ventricular septal defects, removes a pulmonary artery band, and uses a gusset for reinforcement during the surgery.
2. During a surgical procedure, a provider closes multiple ventricular septal defects and removes a previously placed pulmonary artery band without using a gusset.
3. A patient undergoes a surgery in which the provider closes multiple ventricular septal defects, removes a pulmonary artery band, and reinforces the repair with a gusset.
4. A provider performs the closure of multiple ventricular septal defects and removes a pulmonary artery band, but does not use a gusset for reinforcement.
5. During a surgical procedure, a provider closes multiple ventricular septal defects and removes a previously placed pulmonary artery band, without the need for a gusset.
6. A patient undergoes a surgery in which the provider closes multiple ventricular septal defects, removes a pulmonary artery band, and reinforces the repair with a gusset made of autologous tissue.
7. A provider performs the closure of multiple ventricular septal defects and removes a pulmonary artery band, without the need for a gusset or patch graft.
8. During a surgical procedure, a provider closes multiple ventricular septal defects and removes a previously placed pulmonary artery band, using a patch graft for reinforcement.
9. A patient undergoes a surgery in which the provider closes multiple ventricular septal defects, removes a pulmonary artery band, and reinforces the repair with a gusset made of preserved tissue from a donor.
10. A provider performs the closure of multiple ventricular septal defects and removes a pulmonary artery band, without the need for a gusset or patch graft, using a minimally invasive approach.