How To Use CPT Code 33697

CPT 33697 describes the complete repair of tetralogy of Fallot with pulmonary atresia, including the construction of a conduit from the right ventricle to the pulmonary artery and closure of the ventricular 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 33697?

CPT 33697 is used to describe the complete repair of tetralogy of Fallot with pulmonary atresia. This procedure involves the closure of the ventricular septal defect and the creation of a conduit from the right ventricle to the pulmonary artery. It is performed to bypass the obstruction of blood flow caused by the underdevelopment or absence of the pulmonary valve.

2. Official Description

The official description of CPT code 33697 is the complete repair of tetralogy of Fallot with pulmonary atresia, including the construction of a conduit from the right ventricle to the pulmonary artery and closure of the ventricular septal defect. Please note that if a systemic-to-pulmonary artery shunt is performed in conjunction with this procedure, it should be reported separately using CPT code 33924.

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. An incision is made in the chest, typically a median sternotomy, to access the heart.
3. The patient is placed on cardiopulmonary bypass (CPB) to temporarily take over the function of the heart and lungs.
4. The provider approaches the ventricular septal defect either through the atrium or the ventricle and closes the defect using a patch graft, typically made of polytetrafluoroethylene (PTFE).
5. The provider examines the right ventricular outflow tract and decides to place a conduit, or tube-shaped graft, from the right ventricle to the distal pulmonary artery.
6. Incisions are made in the pulmonary artery and the right ventricle, and the ends of the conduit are connected to these incisions.
7. The patient is taken off CPB, and the incisions in the heart are closed.
8. The provider checks for bleeding, removes any instruments, and finally closes the incision in the chest.

4. Qualifying circumstances

CPT 33697 is performed on patients with tetralogy of Fallot and pulmonary atresia. These patients have a ventricular septal defect, pulmonary stenosis, right ventricular hypertrophy, and an aorta positioned over the ventricular septal defect. The procedure is performed by a qualified healthcare professional and requires the use of a conduit to bypass the obstruction of blood flow caused by the underdevelopment or absence of the pulmonary valve.

5. When to use CPT code 33697

CPT code 33697 should be used when performing a complete repair of tetralogy of Fallot with pulmonary atresia, including the construction of a conduit from the right ventricle to the pulmonary artery and closure of the ventricular septal defect. It should not be used for other procedures or repairs unrelated to tetralogy of Fallot with pulmonary atresia.

6. Documentation requirements

To support a claim for CPT 33697, the healthcare professional must document the following information:

• Patient’s diagnosis of tetralogy of Fallot with pulmonary atresia
• Details of the procedure performed, including the closure of the ventricular septal defect and the construction of the conduit
• Date of the procedure
• Start and end time of the procedure
• Any additional relevant information or complications encountered during the procedure
• Signature of the healthcare professional performing the procedure

7. Billing guidelines

When billing for CPT 33697, ensure that the procedure meets the criteria for a complete repair of tetralogy of Fallot with pulmonary atresia. It is important to report any additional procedures or repairs separately using the appropriate CPT codes. Take note of any Medicare changes or specific billing requirements that may apply.

8. Historical information

CPT 33697 was added to the Current Procedural Terminology system on January 1, 1994. It was later added to the Inpatient Only (IPO) list for Medicare in 2017.

9. Examples

1. A provider performs a complete repair of tetralogy of Fallot with pulmonary atresia, including the construction of a conduit from the right ventricle to the pulmonary artery and closure of the ventricular septal defect.
2. A patient with tetralogy of Fallot and pulmonary atresia undergoes a surgical procedure to bypass the obstruction of blood flow and close the ventricular septal defect.
3. A healthcare professional performs a repair procedure for a patient with tetralogy of Fallot and pulmonary atresia, using a conduit to improve blood flow and close the ventricular septal defect.
4. A qualified provider performs a complete repair of tetralogy of Fallot with pulmonary atresia, creating a conduit from the right ventricle to the pulmonary artery and closing the ventricular septal defect.
5. A patient with tetralogy of Fallot and pulmonary atresia undergoes a surgical procedure to correct the heart defects, including the construction of a conduit and closure of the ventricular septal defect.
6. A healthcare professional performs a repair procedure for a patient with tetralogy of Fallot and pulmonary atresia, improving blood flow and closing the ventricular septal defect using a conduit.
7. A provider performs a complete repair of tetralogy of Fallot with pulmonary atresia, including the creation of a conduit and closure of the ventricular septal defect.