How To Use CPT Code 33845

CPT 33845 describes the excision of coarctation of the aorta, with or without associated patent ductus arteriosus, using a graft. 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 33845?

CPT 33845 can be used to describe the surgical procedure performed to excise a stricture or narrowing of the aorta, with or without an associated patent ductus arteriosus. The provider uses a graft, which is a material used to replace the missing tissue or structure, to repair the affected area.

2. Official Description

The official description of CPT code 33845 is: ‘Excision of coarctation of aorta, with or without associated patent ductus arteriosus; with graft.’

3. Procedure

1. The patient is appropriately prepped and anesthetized for the procedure.
2. The provider performs a thoracotomy to access the coarctation of the aorta.
3. Vascular clamps are placed on the narrowed area of the aorta.
4. If a patent ductus arteriosus is present, it is ligated and excised, along with the coarctation tissue.
5. A graft, either a tissue graft or a synthetic tube, is attached to the healthy portions of the aorta to bypass the narrowed area.
6. The provider closes the incision with sutures and may place chest or drainage tubes before dressing the chest incision.

4. Qualifying circumstances

CPT 33845 is performed on patients with coarctation of the aorta, a narrowing of the aorta usually close to the ductus arteriosus. The procedure may also involve the repair of an associated patent ductus arteriosus. The use of a graft is necessary to replace the excised tissue and ensure proper blood flow.

5. When to use CPT code 33845

CPT code 33845 should be used when the provider performs the excision of coarctation of the aorta, with or without an associated patent ductus arteriosus, using a graft. It is important to accurately document the details of the procedure to support the use of this code.

6. Documentation requirements

To support a claim for CPT 33845, the provider must document the following information:

• Patient’s diagnosis of coarctation of the aorta and any associated patent ductus arteriosus
• Details of the procedure, including the use of a graft
• Date of the procedure
• Any additional procedures performed, such as ligation and excision of the patent ductus arteriosus
• Any complications or unexpected findings during the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 33845, ensure that the procedure meets the criteria for excision of coarctation of the aorta with a graft. It is important to accurately document the details of the procedure to support the use of this code. There are no specific guidelines regarding reporting CPT 33845 with other codes.

8. Historical information

CPT 33845 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 surgeon performs the excision of coarctation of the aorta, with a graft, on a patient with a severe narrowing of the aorta.
2. A cardiac specialist performs the excision of coarctation of the aorta, with a graft, on a pediatric patient with an associated patent ductus arteriosus.
3. A team of surgeons performs the excision of coarctation of the aorta, with a graft, on an adult patient with a history of heart disease.
4. A cardiothoracic surgeon performs the excision of coarctation of the aorta, with a graft, on a patient with a congenital heart defect.
5. A vascular surgeon performs the excision of coarctation of the aorta, with a graft, on a patient with a recurrent narrowing of the aorta.
6. A pediatric cardiac surgeon performs the excision of coarctation of the aorta, with a graft, on an infant with a complex heart condition.
7. An interventional cardiologist performs the excision of coarctation of the aorta, with a graft, using minimally invasive techniques.
8. A cardiothoracic surgeon performs the excision of coarctation of the aorta, with a graft, on a patient with a history of hypertension.
9. A team of surgeons performs the excision of coarctation of the aorta, with a graft, on a patient with a connective tissue disorder.
10. An adult cardiac surgeon performs the excision of coarctation of the aorta, with a graft, on a patient with a history of multiple heart surgeries.