How To Use CPT Code 33910

CPT 33910 describes a surgical procedure performed to remove a blockage or embolus from the pulmonary artery. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 33910?

CPT 33910 is used to describe a surgical procedure that involves the urgent removal of a blockage or embolus from the pulmonary artery. This life-threatening blockage typically occurs when a blood clot from the leg travels to the heart and obstructs blood flow to the lungs. The procedure includes the use of cardiopulmonary bypass to maintain circulation and oxygenation during the surgery.

2. Official Description

The official description of CPT code 33910 is: ‘Pulmonary artery embolectomy; with cardiopulmonary bypass.’

3. Procedure

1. The provider prepares the patient and administers anesthesia.
2. An incision is made in the chest, typically through a median sternotomy approach.
3. Cardiopulmonary bypass is initiated to temporarily take over the function of the heart and lungs, maintaining blood circulation and oxygenation.
4. An incision is made over the main pulmonary artery to visualize the clot.
5. The provider may attempt mechanical manipulation or use forceps to remove the clot from the artery.
6. The repaired artery is then closed with sutures.
7. The incision in the chest is closed.

4. Qualifying circumstances

CPT 33910 is performed when there is a blockage or embolus in the pulmonary artery that requires urgent removal. This procedure is typically necessary for patients with a blood clot in the leg that has traveled to the heart and is obstructing blood flow to the lungs. The use of cardiopulmonary bypass is a qualifying circumstance for this code.

5. When to use CPT code 33910

CPT code 33910 should be used when a provider performs a pulmonary artery embolectomy with the assistance of cardiopulmonary bypass. This code is appropriate for cases where there is a blockage or embolus in the pulmonary artery that requires urgent removal. It should not be used for procedures performed without cardiopulmonary bypass or for other types of pulmonary artery surgeries.

6. Documentation requirements

To support a claim for CPT 33910, the provider must document the following information:

• The reason for the procedure, including the presence of a blockage or embolus in the pulmonary artery
• Details of the surgical approach, such as the use of a median sternotomy
• Documentation of the use of cardiopulmonary bypass
• The specific steps taken during the procedure, including the incision, clot removal technique, and artery repair
• The closure of the incisions
• Any additional details or complications encountered during the surgery

7. Billing guidelines

When billing for CPT 33910, it is important to ensure that the procedure meets the criteria for this code, including the use of cardiopulmonary bypass. It should not be reported with other codes unless there are specific circumstances that warrant additional reimbursement, such as the complexity of the procedure. In such cases, modifier 22, Unusual procedural service, may be appended to indicate the extra time or highly complex trauma involved. It is also important to note that CPT 33910 is listed as an inpatient-only (IPO) procedure for Medicare billing.

8. Historical information

CPT 33910 was added to the Current Procedural Terminology system on January 1, 1990. The code has not undergone any updates since its addition. In 2017, it was added to the Inpatient Only (IPO) list for Medicare billing.

9. Examples

1. A patient presents with a life-threatening blood clot in the pulmonary artery. The provider performs a pulmonary artery embolectomy using cardiopulmonary bypass to remove the blockage and restore blood flow to the lungs.
2. During surgery, the provider discovers a large embolus obstructing the pulmonary artery. They perform a pulmonary artery embolectomy with the assistance of cardiopulmonary bypass to remove the clot and ensure proper circulation.
3. A patient with a history of deep vein thrombosis develops a pulmonary embolism. The provider performs an urgent pulmonary artery embolectomy using cardiopulmonary bypass to remove the clot and prevent further complications.
4. Following a traumatic injury, a patient develops a pulmonary embolism. The provider performs a pulmonary artery embolectomy with the use of cardiopulmonary bypass to remove the blockage and restore normal blood flow.
5. A patient with a known clotting disorder presents with a pulmonary embolism. The provider performs a pulmonary artery embolectomy using cardiopulmonary bypass to remove the clot and prevent further complications.
6. During a routine surgery, the provider discovers a clot in the pulmonary artery. They perform a pulmonary artery embolectomy with the assistance of cardiopulmonary bypass to remove the blockage and ensure proper circulation.
7. A patient with a history of deep vein thrombosis experiences sudden shortness of breath. The provider performs an emergency pulmonary artery embolectomy using cardiopulmonary bypass to remove the clot and restore normal blood flow.
8. Following a motor vehicle accident, a patient develops a pulmonary embolism. The provider performs a pulmonary artery embolectomy with the use of cardiopulmonary bypass to remove the blockage and prevent further complications.
9. A patient with a known clotting disorder presents with a pulmonary embolism. The provider performs a pulmonary artery embolectomy using cardiopulmonary bypass to remove the clot and restore normal blood flow.