How To Use CPT Code 33858

CPT 33858 describes the repair procedure for a thoracic aortic aneurysm involving the ascending aorta. 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 33858?

CPT 33858 is used to describe a specific repair procedure for a thoracic aortic aneurysm involving the ascending aorta. This code is used when a provider performs a graft on the ascending aorta to repair a dissection. The procedure may also include the use of cardiopulmonary bypass and the suspension of the aortic valve, if necessary.

2. Official Description

The official description of CPT code 33858 is: ‘Ascending aorta graft, with cardiopulmonary bypass, includes valve suspension, when performed; for aortic dissection.’

3. Procedure

1. The provider begins by preparing and anesthetizing the patient.
2. A sternotomy is performed to access the chest.
3. Cardiopulmonary bypass (CPB) is initiated to temporarily take over the function of the heart and lungs.
4. The provider evaluates the patient’s aortic valve, root, ascending aorta, and arch to identify the area of intimal dissection.
5. The affected section of the ascending aorta is excised.
6. A composite Dacron tube graft is sewn at the distal end near the origin of the aorta at the heart.
7. If necessary, the provider suspends the aortic valve into the graft to a desirable height and sutures it.
8. The tube graft is connected to the other end of the opened aorta to create a continuous path.
9. The provider disconnects the CPB and may rewarm the patient if necessary.
10. The chest is closed in layers with sutures.

4. Qualifying circumstances

CPT 33858 is used for patients with aortic dissection who require a repair procedure involving the ascending aorta. The procedure may include the use of cardiopulmonary bypass and the suspension of the aortic valve, if necessary.

5. When to use CPT code 33858

CPT code 33858 should be used when a provider performs a repair procedure on the ascending aorta for aortic dissection. It is important to ensure that the procedure meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT 33858, the provider must document the following information:

• Patient’s diagnosis of aortic dissection
• Details of the repair procedure performed, including the use of cardiopulmonary bypass and the suspension of the aortic valve, if applicable
• Date of the procedure
• Any additional relevant information or complications encountered during the procedure
• Signature of the provider

7. Billing guidelines

When billing for CPT 33858, ensure that the procedure meets the specific criteria outlined in the code description. It is important to accurately document the details of the procedure and any additional services provided. Review the documentation carefully to ensure accurate coding and billing.

8. Historical information

CPT 33858 was added to the Current Procedural Terminology system on January 1, 2020. It was also added to the Inpatient Only (IPO) list for Medicare reimbursement.

9. Examples

1. A provider performs an ascending aorta graft with cardiopulmonary bypass and valve suspension for a patient with aortic dissection.
2. A patient undergoes a repair procedure on the ascending aorta for aortic dissection, which includes the use of cardiopulmonary bypass and the suspension of the aortic valve.
3. A provider performs a graft on the ascending aorta to repair a dissection, utilizing cardiopulmonary bypass and suspending the aortic valve to a desirable height.
4. An ascending aorta repair procedure is performed for a patient with aortic dissection, involving the use of cardiopulmonary bypass and the suspension of the aortic valve.
5. A provider performs an ascending aorta graft with cardiopulmonary bypass and valve suspension for a patient with aortic dissection.
6. A patient undergoes a repair procedure on the ascending aorta for aortic dissection, which includes the use of cardiopulmonary bypass and the suspension of the aortic valve.
7. A provider performs a graft on the ascending aorta to repair a dissection, utilizing cardiopulmonary bypass and suspending the aortic valve to a desirable height.
8. An ascending aorta repair procedure is performed for a patient with aortic dissection, involving the use of cardiopulmonary bypass and the suspension of the aortic valve.
9. A provider performs an ascending aorta graft with cardiopulmonary bypass and valve suspension for a patient with aortic dissection.
10. A patient undergoes a repair procedure on the ascending aorta for aortic dissection, which includes the use of cardiopulmonary bypass and the suspension of the aortic valve.