How To Use CPT Code 33688

CPT 33688 describes the closure of a single ventricular septal defect, with or without a patch, and 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 33688?

CPT 33688 is used to describe the surgical procedure performed to close a single ventricular septal defect (VSD) in the heart. This procedure may involve the use of a patch or sutures to close the hole in the septum between the ventricles. Additionally, the code includes the removal of a pulmonary artery band, which may have been previously placed to temporarily treat the VSD. The provider may also reinforce the patch on the pulmonary artery with a gusset if necessary.

2. Official Description

The official description of CPT code 33688 is: ‘Closure of single ventricular septal defect, with or without patch; with removal of pulmonary artery band, with or without gusset.’

3. Procedure

1. The provider begins by making 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 heart and examines the ventricular septal defect.
4. Based on the location and characteristics of the defect, the provider determines whether to approach it from the atrium or ventricle.
5. The defect is closed using a patch or sutures to prevent the mixing of oxygenated and deoxygenated blood.
6. If a pulmonary artery band was previously placed, it is removed during the procedure.
7. The provider may also remove scar tissue and reconstruct the pulmonary artery by connecting the ends or using a patch.
8. Once the repairs are complete, the patient is taken off CPB, and the incisions in the heart and chest are closed.

4. Qualifying circumstances

CPT 33688 is performed on patients with a single ventricular septal defect that requires closure. This defect is a congenital condition in which there is a hole in the wall (septum) between the ventricles of the heart. The procedure is typically performed by a cardiac surgeon and may involve the use of a patch or sutures to close the defect. The removal of a pulmonary artery band and the reinforcement of the patch with a gusset may also be necessary in certain cases.

5. When to use CPT code 33688

CPT code 33688 should be used when a provider performs the closure of a single ventricular septal defect, with or without a patch, and removes a pulmonary artery band, with or without a gusset. This code is appropriate for cases where these specific procedures are performed. It should not be used for other types of cardiac repairs or interventions.

6. Documentation requirements

To support a claim for CPT code 33688, the provider must document the following information:

• Patient’s diagnosis of a single ventricular septal defect
• Details of the closure procedure, including the use of a patch or sutures
• Documentation of the removal of a pulmonary artery band, if applicable
• Description of any additional procedures performed, such as the reinforcement of the patch with a gusset
• Date of the procedure
• Signature of the performing provider

7. Billing guidelines

When billing for CPT code 33688, ensure that the procedure performed matches the description of the code. It is important to accurately document the closure of a single ventricular septal defect, the removal of a pulmonary artery band, and any additional procedures performed. CPT code 33688 should not be reported with other codes unless they are distinct and separate procedures. It is essential to follow the specific guidelines provided by the payer and ensure proper documentation to support the claim.

8. Historical information

CPT code 33688 was added to the Current Procedural Terminology system on January 1, 1990. The code underwent a change on January 1, 2007, with an updated description. Additionally, it was added to the Inpatient Only (IPO) list for Medicare in 2017.

9. Examples

1. A cardiac surgeon performs the closure of a single ventricular septal defect using a patch and removes a previously placed pulmonary artery band.
2. During the procedure, the provider reinforces the patch on the pulmonary artery with a gusset to ensure its stability.
3. A patient with a single ventricular septal defect undergoes surgical intervention, which includes the closure of the defect and the removal of a pulmonary artery band.
4. The provider performs the closure of a single ventricular septal defect using sutures and removes a pulmonary artery band without the need for a patch or gusset.
5. A pediatric cardiac surgeon performs the closure of a single ventricular septal defect, removes a pulmonary artery band, and reinforces the patch on the pulmonary artery with a gusset.
6. During the procedure, the provider excises scar tissue and reconstructs the pulmonary artery by connecting the ends without the use of a patch.