How To Use CPT Code 33690

CPT 33690 describes the procedure of banding the pulmonary artery to reduce pulmonary blood flow and prepare the heart for future definitive procedures. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 33690?

CPT 33690 is a code used to describe the procedure of banding the pulmonary artery. This procedure involves placing a band, typically made of a material like umbilical tape, around the aortopulmonary trunk, aorta, and pulmonary artery. The purpose of this band is to restrict pulmonary blood flow, protect pulmonary vessels, and prepare the heart for more definitive procedures in the future.

2. Official Description

The official description of CPT code 33690 is: ‘Banding of pulmonary artery.’

3. Procedure

1. The provider makes an incision in the chest, typically a left anterior thoracotomy, to access the heart.
2. The main pulmonary artery and aorta are exposed.
3. The provider prepares the band and selects a location in the mid portion of the main pulmonary trunk.
4. The band is placed around the aortopulmonary trunk, aorta, and pulmonary artery, restricting pulmonary blood flow.
5. Sutures and pledgets are used to secure the band and prevent movement.
6. Hemoclips may be used to adjust the band circumference.
7. The provider checks for bleeding, removes any instruments, and closes the incision in the chest.

4. Qualifying circumstances

CPT 33690 is typically performed as part of staged procedures to correct or modify multiple congenital cardiac anomalies. It is used when there is a need to reduce pulmonary blood flow, protect pulmonary vessels, and prepare the heart for future definitive procedures. Modifier 63 should not be reported in conjunction with CPT 33690.

5. When to use CPT code 33690

CPT code 33690 should be used when the provider performs the banding of the pulmonary artery procedure. It is important to ensure that the procedure is performed for the appropriate clinical indications and that the patient meets the criteria for this specific procedure.

6. Documentation requirements

To support a claim for CPT 33690, the provider must document the following information:

• Clinical indications for the procedure
• Details of the procedure performed, including the location of the band placement
• Any additional procedures performed in conjunction with the banding of the pulmonary artery
• Any complications or adverse events that occurred during or after the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 33690, it is important to follow the appropriate billing guidelines. Ensure that the procedure is performed by a qualified provider and that the documentation supports the medical necessity of the procedure. Modifier 63 should not be reported in conjunction with CPT 33690. It is also important to review any specific billing guidelines provided by payers to ensure accurate and timely reimbursement.

8. Historical information

CPT 33690 was added to the Current Procedural Terminology system on January 1, 1990. In 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A provider performs banding of the pulmonary artery as part of a staged procedure to correct multiple congenital cardiac anomalies in an infant.
2. A patient with a ventricular septal defect undergoes banding of the pulmonary artery to reduce pulmonary blood flow and prepare for future corrective procedures.
3. A provider performs banding of the pulmonary artery in a patient with complex congenital heart disease to protect pulmonary vessels and optimize cardiac function.
4. As part of a hybrid approach stage 1 procedure, a provider applies right and left pulmonary artery bands using CPT code 33620.
5. A patient with total anomalous pulmonary venous connection undergoes repair, which includes banding of the pulmonary artery.