How To Use CPT Code 33730

CPT 33730 describes the complete repair of anomalous pulmonary venous return, which is a congenital condition where all four pulmonary veins fail to reach the left atrium of the heart. 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 33730?

CPT 33730 is used to describe the complete repair of anomalous pulmonary venous return, a condition where all four pulmonary veins fail to reach the left atrium of the heart. This procedure involves disconnecting the pulmonary veins from their right atrium attachments and reattaching them to the back of the left atrium. The provider may also close any abnormal veins that are carrying pulmonary or oxygenated blood to the heart and close any atrial septal defects present.

2. Official Description

The official description of CPT code 33730 is: ‘Complete repair of anomalous pulmonary venous return (supracardiac, intracardiac, or infracardiac types).’ It is important to note that modifier 63 should not be reported in conjunction with this code. For partial anomalous pulmonary venous return, use CPT code 33724. For repair of pulmonary venous stenosis, use CPT code 33726. Additionally, CPT code 33730 was added to the Current Procedural Terminology system on January 1, 1990, and there have been no updates to the code since its addition.

3. Procedure

1. The provider begins by making an incision in the chest wall to access the heart.
2. They may use a median sternotomy incision, which involves incising the sternum in the middle to open the chest.
3. If necessary, the patient may be placed on cardiopulmonary bypass, which temporarily takes over the function of the heart and lungs during the surgery.
4. The provider then incises the pericardium, the double-layered membrane covering the heart.
5. Next, they disconnect the pulmonary veins from their right atrium attachments and reattach them to the back of the left atrium.
6. Any abnormal veins carrying pulmonary or oxygenated blood to the heart are tied off, and any atrial septal defects are closed.
7. The provider discontinues cardiopulmonary bypass and restarts the heart.
8. Finally, they ensure there is no bleeding and close the chest wall by suturing the tissues in layers.

4. Qualifying circumstances

CPT 33730 is performed on patients with anomalous pulmonary venous return, a congenital condition where all four pulmonary veins fail to reach the left atrium of the heart. This condition is usually associated with an atrial septal defect, a hole in the tissue wall that separates the right and left atrium. The procedure is typically performed by a cardiothoracic surgeon or a specialist trained in congenital heart defects.

5. When to use CPT code 33730

CPT code 33730 should be used when a provider performs a complete repair of anomalous pulmonary venous return. It is important to note that this code should not be reported with modifier 63. If the repair is for partial anomalous pulmonary venous return, CPT code 33724 should be used. For the repair of pulmonary venous stenosis, CPT code 33726 is appropriate.

6. Documentation requirements

To support a claim for CPT code 33730, the provider must document the following information:

• Patient’s diagnosis of anomalous pulmonary venous return
• Details of the complete repair procedure performed
• Date of the procedure
• Any additional procedures performed, such as closure of atrial septal defects
• Any complications or unexpected findings during the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 33730, ensure that the procedure performed is a complete repair of anomalous pulmonary venous return. Modifier 63 should not be reported with this code. It is important to note that CPT code 33730 was added to the Medicare Inpatient Only (IPO) list in 2017, meaning it is only eligible for reimbursement when performed on an inpatient basis. It is also important to consider any additional procedures performed during the same operative session and follow the appropriate coding guidelines for reporting them.

8. Historical information

CPT code 33730 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition. It is important to note that this code is listed as an inpatient-only procedure by Medicare.

9. Examples

1. A cardiothoracic surgeon performing a complete repair of anomalous pulmonary venous return in a newborn with supracardiac type.
2. A specialist trained in congenital heart defects repairing anomalous pulmonary venous return in a child with intracardiac type.
3. A cardiothoracic surgeon performing a complete repair of anomalous pulmonary venous return in an adult with infracardiac type.
4. A provider performing a complete repair of anomalous pulmonary venous return in a patient with associated atrial septal defect closure.
5. A cardiothoracic surgeon repairing total anomalous pulmonary venous return in an infant.
6. A specialist trained in congenital heart defects performing a repair of mixed total and partial anomalous pulmonary venous return in a child.
7. A provider performing a complete repair of anomalous pulmonary venous return in a patient with additional procedures, such as closure of atrial septal defects.
8. A cardiothoracic surgeon repairing anomalous pulmonary venous return in a patient with pulmonary venous stenosis.
9. A specialist trained in congenital heart defects performing a complete repair of anomalous pulmonary venous return in a patient with associated Scimitar syndrome.