How To Use CPT Code 33970

CPT 33970 describes the insertion of an intra-aortic balloon assist device through the femoral artery using an open approach. 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 33970?

CPT 33970 is used to describe the procedure of inserting an intra-aortic balloon assist device through the femoral artery using an open approach. This code is used when the provider makes an incision through the skin and underlying tissue to expose the femoral artery, and then inserts the balloon catheter into the aorta to support heart function in patients with an interrupted blood supply.

2. Official Description

The official description of CPT code 33970 is: ‘Insertion of intra-aortic balloon assist device through the femoral artery, open approach.’

3. Procedure

1. The provider prepares the patient and chooses the appropriate size of the balloon.
2. An incision is made over the femoral artery to expose the vessel.
3. The provider dissects the femoral artery and ties off small arterial branches.
4. The femoral artery is clamped, and the balloon catheter is prepped.
5. The provider opens or punctures the femoral artery and inserts the intra-aortic balloon catheter.
6. The catheter is maneuvered to be near the origin of the subclavian and sutured in place.
7. The balloon catheter is connected to the console and the system is emptied of helium.
8. The catheter is connected to pressure tubing to monitor aortic pressure.
9. The provider initiates counterpulsation, monitoring for timing errors.
10. The balloon inflates at the start of diastole and deflates at the beginning of systole to support heart function.
11. When the patient’s condition improves, the provider weans the patient from the device and ends the procedure.

4. Qualifying circumstances

CPT 33970 is performed in patients with an interrupted blood supply to improve heart function. It is used when the provider inserts an intra-aortic balloon assist device through the femoral artery using an open approach. This procedure is typically performed by a cardiovascular surgeon or an interventional cardiologist.

5. When to use CPT code 33970

CPT code 33970 should be used when the provider performs the insertion of an intra-aortic balloon assist device through the femoral artery using an open approach. It is important to ensure that the procedure is documented accurately and that the medical necessity for the use of the device is clearly stated in the patient’s medical record.

6. Documentation requirements

To support a claim for CPT 33970, the provider must document the following information:

• Medical necessity for the procedure
• Details of the procedure, including the approach used (open approach through the femoral artery)
• Size of the balloon catheter used
• Date and time of the procedure
• Any complications or adverse events that occurred during the procedure
• Any additional procedures performed in conjunction with the insertion of the intra-aortic balloon assist device
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 33970, it is important to ensure that the procedure is performed using an open approach through the femoral artery. The provider should also document the medical necessity for the procedure and any additional procedures performed. It is important to follow the specific guidelines provided by the payer to ensure accurate and timely reimbursement.

8. Historical information

CPT 33970 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 reimbursement.

9. Examples

1. A cardiovascular surgeon performing the insertion of an intra-aortic balloon assist device through the femoral artery using an open approach in a patient with severe coronary artery disease.
2. An interventional cardiologist inserting an intra-aortic balloon assist device through the femoral artery using an open approach in a patient with cardiogenic shock.
3. A cardiovascular surgeon performing the insertion of an intra-aortic balloon assist device through the femoral artery using an open approach in a patient undergoing high-risk cardiac surgery.
4. An interventional cardiologist inserting an intra-aortic balloon assist device through the femoral artery using an open approach in a patient with acute myocardial infarction and hemodynamic instability.
5. A cardiovascular surgeon performing the insertion of an intra-aortic balloon assist device through the femoral artery using an open approach in a patient with severe aortic stenosis undergoing transcatheter aortic valve replacement.
6. An interventional cardiologist inserting an intra-aortic balloon assist device through the femoral artery using an open approach in a patient with refractory heart failure awaiting heart transplantation.
7. A cardiovascular surgeon performing the insertion of an intra-aortic balloon assist device through the femoral artery using an open approach in a patient with acute decompensated heart failure.
8. An interventional cardiologist inserting an intra-aortic balloon assist device through the femoral artery using an open approach in a patient undergoing percutaneous coronary intervention with high-risk features.
9. A cardiovascular surgeon performing the insertion of an intra-aortic balloon assist device through the femoral artery using an open approach in a patient with severe aortic regurgitation and cardiogenic shock.
10. An interventional cardiologist inserting an intra-aortic balloon assist device through the femoral artery using an open approach in a patient with acute pulmonary embolism and hemodynamic instability.