How To Use CPT Code 33767

CPT 33767 describes the surgical procedure known as the bidirectional Glenn procedure, which involves creating a shunt between the superior vena cava and the right pulmonary artery. 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 33767?

CPT 33767 is used to describe a surgical procedure called the bidirectional Glenn procedure. This procedure involves creating a shunt between the superior vena cava and the right pulmonary artery. The purpose of this shunt is to divert deoxygenated blood directly to both lungs, bypassing the defective right chamber of the heart. The bidirectional Glenn procedure is performed to improve oxygenation in patients with certain congenital heart defects.

2. Official Description

The official description of CPT code 33767 is: ‘Shunt; superior vena cava to pulmonary artery for flow to both lungs (bidirectional Glenn procedure).’ This code specifically refers to the surgical creation of a shunt between the superior vena cava and the right pulmonary artery to redirect blood flow for improved oxygenation.

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. The provider makes an incision in the chest wall to open the chest.
3. The patient is placed on cardiopulmonary bypass, and their body may be cooled to temporarily suspend blood flow.
4. The provider occludes the end of the superior vena cava where it joins with the right atrium.
5. An incision is made in the right pulmonary artery.
6. One end of the pulmonary artery is occluded at its junction with the heart, and the other end is used to create an end-to-end passageway between the superior vena cava and the right pulmonary artery.
7. The provider discontinues cardiopulmonary bypass and restarts the heart.
8. All bleeding is stopped, and the chest wall is closed by suturing the soft tissues in layers.

4. Qualifying circumstances

The bidirectional Glenn procedure is performed on patients with certain congenital heart defects that require redirection of blood flow for improved oxygenation. This procedure is typically performed by a cardiovascular surgeon. It is important to note that not all patients with congenital heart defects will require or be eligible for the bidirectional Glenn procedure. The decision to perform this procedure is based on the patient’s specific condition and the recommendation of the healthcare provider.

5. When to use CPT code 33767

CPT code 33767 should be used when the bidirectional Glenn procedure is performed to create a shunt between the superior vena cava and the right pulmonary artery. This code is specific to the bidirectional Glenn procedure and should not be used for other shunting procedures or surgical interventions. It is important to accurately document the procedure and use the appropriate CPT code to ensure proper billing and reimbursement.

6. Documentation requirements

To support a claim for CPT code 33767, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for the bidirectional Glenn procedure
• Date of the procedure
• Details of the procedure, including the incision, occlusion of the superior vena cava, incision in the right pulmonary artery, and creation of the shunt
• Any complications or additional procedures performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 33767, ensure that the procedure performed is the bidirectional Glenn procedure, creating a shunt between the superior vena cava and the right pulmonary artery. It is important to accurately document the procedure and use the appropriate CPT code to ensure proper billing and reimbursement. It is also important to follow any specific billing guidelines provided by insurance payers or regulatory authorities.

8. Historical information

CPT code 33767 was added to the Current Procedural Terminology system on January 1, 1994. The code has not undergone any updates since its addition. It is important to stay updated on any changes or revisions to CPT codes to ensure accurate coding and billing.

9. Examples

1. A cardiovascular surgeon performs the bidirectional Glenn procedure on a pediatric patient with a complex congenital heart defect.
2. A patient with a history of congenital heart disease undergoes the bidirectional Glenn procedure to improve oxygenation.
3. A healthcare provider performs the bidirectional Glenn procedure on an adult patient with a previously repaired congenital heart defect.
4. A patient with a single ventricle defect undergoes the bidirectional Glenn procedure as part of their staged surgical treatment plan.
5. A pediatric patient with hypoplastic left heart syndrome receives the bidirectional Glenn procedure to redirect blood flow for improved oxygenation.
6. A healthcare provider performs the bidirectional Glenn procedure on a patient with pulmonary atresia and intact ventricular septum.
7. A patient with tricuspid atresia undergoes the bidirectional Glenn procedure to improve oxygenation.
8. A healthcare provider performs the bidirectional Glenn procedure on a patient with double outlet right ventricle.
9. A pediatric patient with tetralogy of Fallot receives the bidirectional Glenn procedure as part of their overall treatment plan.
10. A patient with a complex congenital heart defect undergoes the bidirectional Glenn procedure to improve their overall cardiac function.