How To Use CPT Code 33851

CPT 33851 describes the excision and repair of coarctation of the aorta, with or without associated patent ductus arteriosus, using either the left subclavian artery or prosthetic material as a gusset for enlargement. 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 33851?

CPT 33851 is used to describe the surgical procedure performed to excise tissues that are narrowing the aorta and repair any associated patent ductus arteriosus. The provider may use either the left subclavian artery or a prosthetic material as a gusset to enlarge the aorta. This code is used when the repair is performed using these specific techniques.

2. Official Description

The official description of CPT code 33851 is: ‘Excision of coarctation of aorta, with or without associated patent ductus arteriosus; repair using either left subclavian artery or prosthetic material as gusset for enlargement.’

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. The provider incises along the narrowed area of the aorta.
6. Either a synthetic patch or prosthetic material, or a flap from the left subclavian artery, is used to widen the vessel.
7. The incision is closed with sutures, and chest or drainage tubes may be placed.
8. The chest incision is dressed.

4. Qualifying circumstances

CPT 33851 is performed on patients with coarctation of the aorta, a narrowing of the aorta usually close to the ductus arteriosus. The repair may also involve the excision of associated patent ductus arteriosus. The procedure is performed using either the left subclavian artery or prosthetic material as a gusset for enlargement.

5. When to use CPT code 33851

CPT code 33851 should be used when the provider performs the excision of coarctation of the aorta, with or without associated patent ductus arteriosus, and uses either the left subclavian artery or prosthetic material as a gusset for enlargement. This code should not be used for other repair techniques or when different materials are used for the repair.

6. Documentation requirements

To support a claim for CPT 33851, the provider must document the following information:

• Patient’s diagnosis of coarctation of the aorta and any associated patent ductus arteriosus
• Details of the repair technique used, including whether the left subclavian artery or prosthetic material was used
• Date of the procedure
• Any additional procedures performed, such as ligation and excision of patent ductus arteriosus
• Details of the incision and closure technique
• Placement of any chest or drainage tubes
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 33851, ensure that the procedure meets the specific criteria outlined in the code description. The repair must involve the excision of coarctation of the aorta, with or without associated patent ductus arteriosus, using either the left subclavian artery or prosthetic material as a gusset for enlargement. It is important to follow any additional guidelines provided by payers or coding authorities for accurate billing and reimbursement.

8. Historical information

CPT 33851 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 an excision of coarctation of the aorta and repair using the left subclavian artery as a gusset for enlargement.
2. A cardiothoracic surgeon excises coarctation of the aorta and repairs it with a prosthetic material as a gusset for enlargement.
3. A patient undergoes a procedure in which the provider excises coarctation of the aorta and repairs it using the left subclavian artery as a gusset for enlargement.
4. A surgeon performs an excision of coarctation of the aorta and repair using a prosthetic material as a gusset for enlargement.
5. A patient undergoes a procedure in which the provider excises coarctation of the aorta and repairs it using a synthetic patch as a gusset for enlargement.
6. A cardiothoracic surgeon performs an excision of coarctation of the aorta and repair using the left subclavian artery as a gusset for enlargement.
7. A patient undergoes a procedure in which the provider excises coarctation of the aorta and repairs it using a prosthetic material as a gusset for enlargement.
8. A surgeon performs an excision of coarctation of the aorta and repair using the left subclavian artery as a gusset for enlargement.
9. A patient undergoes a procedure in which the provider excises coarctation of the aorta and repairs it using a synthetic patch as a gusset for enlargement.
10. A cardiothoracic surgeon performs an excision of coarctation of the aorta and repair using a prosthetic material as a gusset for enlargement.