How To Use CPT Code 33974

CPT 33974 describes the removal of an intra-aortic balloon assist device from the ascending aorta, including repair of the ascending aorta, with or without graft. 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 33974?

CPT 33974 can be used to describe the removal of an intra-aortic balloon assist device from the ascending aorta, along with the repair of the ascending aorta, with or without graft. This code is used when the provider performs the procedure once the patient stabilizes, following the previous insertion of the intra-aortic balloon.

2. Official Description

The official description of CPT code 33974 is: ‘Removal of intra-aortic balloon assist device from the ascending aorta, including repair of the ascending aorta, with or without graft.’

3. Procedure

1. The provider reopens the sternotomy incision to expose the site of the balloon catheter insertion or graft.
2. The provider removes the previously inserted intra-aortic balloon catheter, either by tying off the catheter entry point and cutting the sutures, or by cutting the catheter out of the graft and removing it from the aorta.
3. If a graft was used, the provider tapes the graft and catheter near the aortotomy, clamps the graft, cuts it, removes any clots, and oversews and sutures in the graft.
4. Finally, the provider closes the incision with sutures.

4. Qualifying circumstances

Patients eligible to receive CPT 33974 services are those who have previously had an intra-aortic balloon assist device inserted and now require its removal. The repair of the ascending aorta, with or without graft, may also be necessary. The procedure is performed once the patient stabilizes and is typically done following a sternotomy incision.

5. When to use CPT code 33974

CPT code 33974 should be used when the provider performs the removal of an intra-aortic balloon assist device from the ascending aorta, along with the repair of the ascending aorta, with or without graft. This code is appropriate when the patient has previously had the device inserted and now requires its removal. It is important to note that this code should not be used for the initial insertion of the intra-aortic balloon.

6. Documentation requirements

To support a claim for CPT 33974, the provider must document the following information:

• Indication for the removal of the intra-aortic balloon assist device
• Details of the repair performed on the ascending aorta, including whether a graft was used
• Date of the procedure
• Specific steps taken during the procedure, such as reopening the sternotomy incision, removing the balloon catheter, and closing the incision
• Any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 33974, ensure that the procedure involves the removal of an intra-aortic balloon assist device from the ascending aorta, along with the repair of the ascending aorta, with or without graft. It is important to note that this code should not be reported for the initial insertion of the intra-aortic balloon. There are specific codes available for different approaches and additional procedures related to the insertion and removal of the device, so it is crucial to select the appropriate code based on the specific circumstances of the procedure.

8. Historical information

CPT 33974 was added to the Current Procedural Terminology system on January 1, 1994. It was later added to the Inpatient Only (IPO) list for Medicare in 2017.

9. Examples

1. A patient who previously had an intra-aortic balloon assist device inserted requires its removal from the ascending aorta, along with repair of the ascending aorta using a graft.
2. Following the stabilization of a patient, the provider performs the removal of an intra-aortic balloon assist device from the ascending aorta, without the need for repair.
3. A patient who had an intra-aortic balloon assist device inserted now requires its removal from the ascending aorta, along with repair of the ascending aorta without the use of a graft.
4. After the patient stabilizes, the provider performs the removal of an intra-aortic balloon assist device from the ascending aorta, along with repair of the ascending aorta using a graft.
5. A patient who previously had an intra-aortic balloon assist device inserted requires its removal from the ascending aorta, without the need for repair.
6. Following the stabilization of a patient, the provider performs the removal of an intra-aortic balloon assist device from the ascending aorta, along with repair of the ascending aorta using a graft.
7. A patient who had an intra-aortic balloon assist device inserted now requires its removal from the ascending aorta, along with repair of the ascending aorta without the use of a graft.
8. After the patient stabilizes, the provider performs the removal of an intra-aortic balloon assist device from the ascending aorta, along with repair of the ascending aorta using a graft.
9. A patient who previously had an intra-aortic balloon assist device inserted requires its removal from the ascending aorta, without the need for repair.
10. Following the stabilization of a patient, the provider performs the removal of an intra-aortic balloon assist device from the ascending aorta, along with repair of the ascending aorta using a graft.