How To Use CPT Code 33737

CPT 33737 describes a procedure that involves the removal of the atrial septum or the intentional creation of an opening in the atrial septum, which is the wall of tissue separating the right and left atrium of the heart. This article will cover the official description, procedure details, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 33737?

CPT 33737 is a code used to describe a surgical procedure in which the provider removes the atrial septum or creates an opening in the atrial septum. This procedure is performed on the heart and requires the use of cardiopulmonary bypass. The purpose of this procedure is to alter the flow of oxygenated blood in certain congenital conditions, such as transposition of the great vessels (TGV).

2. Official Description

The official description of CPT code 33737 is: ‘Atrial septectomy or septostomy; open heart, with inflow occlusion.’

3. Procedure

1. The provider makes an incision in the chest wall to access the heart, typically using a median sternotomy incision.
2. The patient is placed on cardiopulmonary bypass, which temporarily takes over the function of the heart and lungs.
3. The provider covers the vena cavae and the azygous vein with tourniquets to temporarily interrupt the venous blood returning to the heart.
4. The provider incises both the left and right atria to access and remove the atrial septum or create an opening in it.
5. Any bleeding is stopped, and the patient is weaned off of bypass.
6. The provider closes the chest wall by suturing the layers of tissue together.

4. Qualifying circumstances

CPT 33737 is typically performed in cases where there is a congenital anomaly, such as transposition of the great vessels (TGV), that requires alteration of the flow of oxygenated blood. The procedure is performed on patients who are appropriately prepped and anesthetized. It is important to note that this procedure is considered an open heart surgery and requires the use of cardiopulmonary bypass.

5. When to use CPT code 33737

CPT code 33737 should be used when the provider performs an atrial septectomy or septostomy procedure on the heart with the use of cardiopulmonary bypass. This code should be used specifically for cases involving the removal of the atrial septum or the creation of an opening in it. It is important to review the documentation and ensure that the procedure meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT code 33737, the provider must document the following information:

• Patient’s diagnosis and the need for the atrial septectomy or septostomy procedure
• Details of the procedure performed, including the specific steps taken
• Use of cardiopulmonary bypass
• Any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 33737, it is important to ensure that the procedure meets the specific criteria outlined in the code description. The procedure must involve the removal of the atrial septum or the creation of an opening in it, and it must be performed on the heart with the use of cardiopulmonary bypass. It is also important to review any additional guidelines or notes provided by the payer to ensure accurate billing.

8. Historical information

CPT code 33737 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 an atrial septectomy on a patient with transposition of the great vessels (TGV) to alter the flow of oxygenated blood.
2. A patient with a congenital heart defect undergoes an atrial septostomy procedure to create an opening in the atrial septum.
3. A provider performs an atrial septectomy on a patient with a complex cardiac condition to improve blood flow and oxygenation.
4. An infant with a critical congenital heart defect undergoes an atrial septostomy to stabilize their condition before further interventions.
5. A provider performs an atrial septectomy on a patient with a history of recurrent pulmonary venous obstruction to improve blood flow.
6. A child with transposition of the great vessels (TGV) undergoes an atrial septostomy to redirect blood flow and improve oxygenation.
7. A provider performs an atrial septectomy on a patient with a complex congenital heart defect to optimize their cardiac function.
8. An adult with a history of transposition of the great vessels (TGV) undergoes an atrial septostomy to alleviate symptoms and improve quality of life.
9. A provider performs an atrial septectomy on a patient with a rare congenital heart condition to improve blood flow and oxygenation.
10. An infant with a critical congenital heart defect undergoes an atrial septostomy to stabilize their condition and prepare for further interventions.