How To Use CPT Code 33800

CPT 33800 describes a surgical procedure known as aortic suspension or aortopexy, which is performed to decompress the trachea in patients with severe tracheomalacia or tracheal compression. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 33800?

CPT 33800 is a code used to describe a surgical procedure called aortic suspension or aortopexy. This procedure involves affixing the aortic arch to the sternum, or breastbone, to open up the trachea in patients with severe tracheomalacia or tracheal compression. By securing the aortic arch in this way, the anterior wall of the trachea is pulled forward, preventing collapse and allowing for improved airflow.

2. Official Description

The official description of CPT code 33800 is: ‘Aortic suspension (aortopexy) for tracheal decompression (eg, for tracheomalacia) (separate procedure)’

3. Procedure

1. The patient is appropriately prepped and anesthetized for the procedure.
2. A bronchoscopy is performed by the provider to confirm the extent of tracheal compression.
3. A left anterior thoracotomy is performed by the provider to gain access to the chest cavity.
4. If necessary, part of the thymus may be removed to improve exposure.
5. The provider retracts part of the lung to locate the vascular ring and examine the esophagus.
6. Sutures are used to tie the arch of the aorta to the underside of the sternum, pulling the anterior wall of the trachea forward.
7. The incision is closed with sutures and chest or drainage tubes may be placed.

4. Qualifying circumstances

CPT 33800 is performed in patients with severe tracheomalacia or tracheal compression. Tracheomalacia is a condition in which the cartilage supporting the trachea becomes loose, leading to tracheal collapse, especially during increased airflow. Tracheal compression refers to the compression or narrowing of the windpipe due to any reason. The procedure is performed to decompress the trachea and improve airflow in these patients.

5. When to use CPT code 33800

CPT code 33800 should be used when aortic suspension or aortopexy is performed as a separate procedure to decompress the trachea in patients with severe tracheomalacia or tracheal compression. It should not be used if the procedure is performed as part of another surgical intervention.

6. Documentation requirements

To support a claim for CPT 33800, the following documentation is required:

• Confirmation of the patient’s diagnosis of severe tracheomalacia or tracheal compression
• Description of the procedure performed, including details of the aortic suspension or aortopexy
• Date of the procedure
• Any additional relevant information, such as the extent of tracheal compression observed during bronchoscopy
• Signature of the performing provider

7. Billing guidelines

When billing for CPT 33800, ensure that the procedure is performed as a separate procedure for tracheal decompression in patients with severe tracheomalacia or tracheal compression. It should not be reported if performed as part of another surgical intervention. There are no specific guidelines regarding reporting CPT 33800 with other codes.

8. Historical information

CPT 33800 was added to the Current Procedural Terminology system on January 1, 1993. In 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A patient with severe tracheomalacia undergoes aortic suspension to decompress the trachea and improve airflow.
2. A child with tracheal compression undergoes aortopexy to alleviate symptoms and improve breathing.
3. A patient with both severe tracheomalacia and tracheal compression undergoes aortic suspension to address both conditions.
4. A surgical team performs aortic suspension as a separate procedure to decompress the trachea in a patient with tracheomalacia and other congenital anomalies.
5. A provider performs aortopexy to relieve tracheal compression caused by an abnormal formation of the aorta in the heart.
6. A patient with tracheomalacia resulting from weakened cartilage undergoes aortic suspension to stabilize the trachea and prevent collapse.
7. A surgical intervention involves aortic suspension to decompress the trachea in a patient with tracheal compression due to an aortic arch aneurysm.
8. A provider performs aortopexy to alleviate tracheal compression caused by an abnormal vascular ring.
9. A patient with severe tracheomalacia undergoes aortic suspension to improve breathing and quality of life.
10. A surgical team performs aortic suspension as a separate procedure to relieve tracheal compression and improve airflow in a patient with a complex medical history.