How To Use CPT Code 33977

CPT 33977 describes the removal of a ventricular assist device (VAD) from a patient’s heart. 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 33977?

CPT 33977 can be used to describe the removal of a previously inserted ventricular assist device (VAD) from a patient’s heart. This procedure is performed when the patient has stabilized after the initial placement of the VAD. It is important to note that this code is applicable to a single ventricle.

2. Official Description

The official description of CPT code 33977 is: ‘Removal of ventricular assist device; extracorporeal, single ventricle.’

3. Procedure

1. The provider prepares the patient and administers anesthesia.
2. An incision is made in the chest, and heparin is administered.
3. The provider turns off the pump for half an hour and initiates cardiopulmonary bypass if necessary.
4. The subcutaneous pocket containing the device is opened, and the inflow and outflow cannula are tied off.
5. All wounds are closed with sutures, and an intra-aortic balloon may be used to stop the cardiopulmonary bypass if needed.

4. Qualifying circumstances

CPT 33977 is performed when a patient has a previously inserted ventricular assist device (VAD) and requires its removal. This procedure is applicable to a single ventricle. It is important to note that the patient must have stabilized after the initial placement of the VAD.

5. When to use CPT code 33977

CPT code 33977 should be used when a provider performs the removal of a ventricular assist device (VAD) from a patient’s heart. It is important to ensure that the patient has stabilized after the initial placement of the VAD and that the procedure is applicable to a single ventricle.

6. Documentation requirements

To support a claim for CPT 33977, the provider must document the following information:

• Patient’s medical history and indication for VAD removal
• Date and duration of the procedure
• Details of the procedure, including the use of cardiopulmonary bypass if applicable
• Any additional procedures performed during the same operative session
• Any complications or unexpected findings
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 33977, ensure that the procedure involves the removal of a ventricular assist device (VAD) from a patient’s heart. It is important to note that this code is applicable to a single ventricle. Consider the use of additional codes if other procedures are performed during the same operative session. Review the specific billing guidelines provided by payers to ensure accurate reporting and reimbursement.

8. Historical information

CPT 33977 was added to the Current Procedural Terminology system on January 1, 1994. It underwent a code change on January 1, 2002, with the description being updated to specify single ventricle support. In 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A patient who had a ventricular assist device (VAD) inserted previously undergoes the removal of the device from their heart.
2. A provider performs the removal of a ventricular assist device (VAD) from a patient’s heart after the patient stabilizes following the initial placement of the device.
3. A single ventricle patient requires the removal of a previously inserted ventricular assist device (VAD) from their heart.
4. A provider performs the removal of a ventricular assist device (VAD) from a patient’s heart, which was initially placed to support their weakened heart.
5. A patient with heart failure undergoes the removal of a ventricular assist device (VAD) from their heart after their condition improves.
6. A provider performs the removal of a ventricular assist device (VAD) from a patient’s heart, allowing the patient’s heart to function without external support.
7. A single ventricle patient requires the removal of a previously inserted ventricular assist device (VAD) from their heart to address complications or device malfunction.
8. A provider performs the removal of a ventricular assist device (VAD) from a patient’s heart as part of a planned procedure to transition the patient to a different treatment modality.
9. A patient who no longer requires the support of a ventricular assist device (VAD) undergoes the removal of the device from their heart.
10. A provider performs the removal of a ventricular assist device (VAD) from a patient’s heart to address infection or other complications associated with the device.