How To Use CPT Code 33967

CPT 33967 describes the percutaneous insertion of an intra-aortic balloon assist device by a healthcare provider. 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 33967?

CPT 33967 can be used to describe the percutaneous insertion of an intra-aortic balloon assist device by a healthcare provider. This code is used when the provider inserts a balloon catheter into the aorta to support the heart function in patients with an interrupted blood supply.

2. Official Description

The official description of CPT code 33967 is: ‘Insertion of intra-aortic balloon assist device, percutaneous.’

3. Procedure

1. The healthcare provider prepares the patient and administers anesthesia.
2. The provider selects the appropriate size of the balloon and inserts the intra-aortic balloon catheter percutaneously through a femoral artery access.
3. Under fluoroscopy guidance, the provider maneuvers the balloon catheter near the origin of the subclavian artery and sutures it in place.
4. The provider connects the balloon catheter to the console, empties the system of helium, and connects the catheter to pressure tubing to monitor aortic pressure.
5. The provider initiates counterpulsation, where the balloon inflates during diastole and deflates during systole, increasing cardiac output and decreasing the work of the left ventricle.
6. Once the patient’s condition improves, the provider takes the necessary steps to wean the patient from the device and end the procedure.

4. Qualifying circumstances

CPT 33967 is performed in patients with an interrupted blood supply to improve heart function. The procedure is typically done percutaneously through a femoral artery access. The patient must meet the criteria for the use of an intra-aortic balloon assist device, and the provider must determine the medical necessity for the procedure.

5. When to use CPT code 33967

CPT code 33967 should be used when a healthcare provider performs the percutaneous insertion of an intra-aortic balloon assist device. This code is appropriate for patients with an interrupted blood supply and when the provider determines that the use of the device is medically necessary.

6. Documentation requirements

To support a claim for CPT 33967, the healthcare provider must document the following information:

• Patient’s medical condition and the need for the intra-aortic balloon assist device
• Details of the procedure, including the size of the balloon, access site, and any complications encountered
• Date and duration of the procedure
• Monitoring of aortic pressure and initiation of counterpulsation
• Progress of the patient and steps taken to wean them from the device
• Provider’s signature

7. Billing guidelines

When billing for CPT 33967, ensure that the procedure is performed percutaneously and that the documentation supports the medical necessity for the use of the intra-aortic balloon assist device. It is important to follow the specific guidelines provided by the payer and use the appropriate modifiers if required. Additionally, be aware of any bundling or unbundling issues with other related codes.

8. Historical information

CPT 33967 was added to the Current Procedural Terminology system on January 1, 2002. The code has undergone changes related to Medicare reimbursement, specifically being added to the Inpatient Only (IPO) list in 2017.

9. Examples

1. A cardiologist performing the percutaneous insertion of an intra-aortic balloon assist device in a patient with severe coronary artery disease.
2. An interventional radiologist inserting an intra-aortic balloon catheter to support heart function in a patient with cardiogenic shock.
3. A cardiovascular surgeon performing the percutaneous insertion of an intra-aortic balloon assist device in a patient undergoing high-risk cardiac surgery.
4. An interventional cardiologist using an intra-aortic balloon assist device to provide temporary circulatory support in a patient with acute myocardial infarction.
5. A cardiac anesthesiologist performing the percutaneous insertion of an intra-aortic balloon catheter in a patient undergoing a complex cardiac procedure.
6. A cardiovascular specialist inserting an intra-aortic balloon assist device to support heart function in a patient with severe heart failure.
7. An interventional radiologist performing the percutaneous insertion of an intra-aortic balloon catheter in a patient with aortic dissection.
8. A cardiac surgeon using an intra-aortic balloon assist device to provide circulatory support during a high-risk cardiac procedure.
9. An interventional cardiologist performing the percutaneous insertion of an intra-aortic balloon catheter in a patient with unstable angina.
10. A cardiovascular specialist inserting an intra-aortic balloon assist device to support heart function in a patient with cardiomyopathy.