How To Use CPT Code 33745

CPT 33745 describes the creation of an intracardiac shunt using stent placement for congenital cardiac anomalies. 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 33745?

CPT 33745 can be used to describe the creation of an intracardiac shunt using stent placement for congenital cardiac anomalies. This code is used when a provider advances a catheter through vessels to reach the heart under imaging guidance and places one or more stents to establish effective intracardiac flow. The procedure may also include left and right heart diagnostic cardiac catheterization for congenital cardiac anomalies and target zone angioplasty if necessary.

2. Official Description

The official description of CPT code 33745 is: ‘Transcatheter intracardiac shunt (TIS) creation by stent placement for congenital cardiac anomalies to establish effective intracardiac flow, including all imaging guidance by the proceduralist, when performed, left and right heart diagnostic cardiac catheterization for congenital cardiac anomalies, and target zone angioplasty, when performed (eg, atrial septum, Fontan fenestration, right ventricular outflow tract, Mustard/Senning/Warden baffles); initial intracardiac shunt.’

3. Procedure

1. The provider makes a small incision and introduces a catheter into a vessel, such as the femoral vein.
2. Under imaging guidance, the provider advances the catheter over a guidewire into the heart.
3. Left and right heart diagnostic cardiac catheterization may be performed to diagnose congenital cardiac anomalies.
4. Target zone angioplasty may be performed to pre-dilate the area where the stent will go or to achieve a therapeutic result.
5. The provider creates an intracardiac shunt by placing one or more stents.
6. Angioplasty in the target area may be performed after stent placement.
7. The catheter is withdrawn and the access site is closed.

4. Qualifying circumstances

CPT 33745 is used for patients with congenital cardiac anomalies who require the creation of an intracardiac shunt using stent placement. The procedure is typically performed by an interventional cardiologist. It is important to note that this code is specific to the initial intracardiac shunt and may include multiple stents in a single location.

5. When to use CPT code 33745

CPT code 33745 should be used when a provider performs the procedure to create an intracardiac shunt using stent placement for congenital cardiac anomalies. It is important to ensure that all the components described in the official description are performed during the procedure.

6. Documentation requirements

To support a claim for CPT 33745, the provider must document the following information:

• Patient’s diagnosis of congenital cardiac anomalies
• Details of the procedure performed, including the use of stent placement, imaging guidance, and any additional diagnostic cardiac catheterization or angioplasty
• Date of the procedure
• Specific congenital cardiac anomalies targeted during the procedure
• Progress made during the procedure and any complications encountered
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 33745, ensure that the procedure meets all the requirements described in the official description. It is important to note that this code should not be reported with other codes for additional shunts. Providers should also consider the location of the testing and the need for both professional and technical components when coding for this procedure.

8. Historical information

CPT 33745 was added to the Current Procedural Terminology system on January 1, 2021. It was also added to the Inpatient Only (IPO) list for Medicare in 2021.

9. Examples

1. A provider creates an intracardiac shunt using stent placement for a patient with an atrial septum anomaly.
2. An interventional cardiologist performs left and right heart diagnostic cardiac catheterization and creates an intracardiac shunt using stent placement for a patient with a Fontan fenestration.
3. A provider performs target zone angioplasty and creates an intracardiac shunt using stent placement for a patient with a right ventricular outflow tract anomaly.
4. An interventional cardiologist creates an intracardiac shunt using stent placement for a patient with Mustard/Senning/Warden baffles.
5. A provider performs left and right heart diagnostic cardiac catheterization, target zone angioplasty, and creates an intracardiac shunt using stent placement for a patient with multiple congenital cardiac anomalies.