How To Use CPT Code 33981

CPT 33981 describes the replacement of a ventricular assist device (VAD) pump in a previously placed device. 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 33981?

CPT 33981 can be used to describe the replacement of a pump in a ventricular assist device (VAD) that has already been implanted in a patient. This code is applicable for the replacement of a pump in one or both ventricles of the heart.

2. Official Description

The official description of CPT code 33981 is: ‘Replacement of extracorporeal ventricular assist device, single or biventricular, pump(s), single or each pump.’

3. Procedure

1. The provider prepares the patient for the procedure and administers anesthesia.
2. An incision is made to access the abdominal pocket where the VAD pump is located.
3. The provider clamps the cannula, which is a small tube inserted into the body to pass instruments into the cavity.
4. The old VAD pump is removed, and a new pump is connected to the cannula.
5. The provider releases the clamps, primes the pump, and activates the device.
6. The new pump is placed into the pocket, and the incision is closed.

4. Qualifying circumstances

CPT 33981 is used when a provider replaces the pump in a previously placed ventricular assist device (VAD) with a new pump. This procedure can be performed in one or both ventricles of the heart. The patient must have a VAD already implanted, and the replacement must be necessary due to device malfunction or other medical reasons.

5. When to use CPT code 33981

CPT code 33981 should be used when a provider performs the replacement of a VAD pump in a patient who already has a VAD implanted. This code should not be used for the initial implantation of a VAD or for the removal of a VAD pump without replacement.

6. Documentation requirements

To support a claim for CPT 33981, the provider must document the following information:

• Indication for the replacement of the VAD pump
• Details of the procedure, including the approach used and any complications encountered
• Specific location of the pump replacement (single or biventricular)
• Any additional procedures performed during the same operative session
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 33981, ensure that the procedure involves the replacement of a VAD pump in a previously implanted device. This code should not be reported for the initial implantation of a VAD or for the removal of a VAD pump without replacement. Consider the specific circumstances of the procedure and any additional services provided during the same operative session when selecting the appropriate codes for billing.

8. Historical information

CPT 33981 was added to the Current Procedural Terminology system on January 1, 2010. The code has not undergone any updates since its addition. It is important to note that as of 2017, this procedure is listed as an Inpatient Only (IPO) service for Medicare patients.

9. Examples

1. A patient with a previously implanted ventricular assist device (VAD) requires the replacement of the pump in one ventricle. The provider performs the procedure to replace the pump, documenting all necessary details for billing.
2. In a biventricular VAD, both pumps need to be replaced due to malfunction. The provider performs the replacement procedure, ensuring accurate documentation for billing purposes.
3. A patient with a single ventricle VAD experiences complications with the pump, requiring its replacement. The provider performs the necessary procedure and documents all relevant information for billing.
4. During an operative session, the provider replaces the pump in a previously implanted VAD and also performs an additional procedure. Both procedures are documented appropriately for billing purposes.
5. A patient with a biventricular VAD requires the replacement of one pump due to device malfunction. The provider performs the replacement procedure and ensures accurate documentation for billing.
6. In a single ventricle VAD, the pump needs to be replaced due to medical reasons. The provider performs the replacement procedure and documents all necessary details for billing.
7. A patient with a previously implanted VAD requires the replacement of both pumps. The provider performs the necessary procedure and ensures accurate documentation for billing purposes.
8. During an operative session, the provider replaces the pump in a biventricular VAD and also performs an additional procedure. Both procedures are documented appropriately for billing purposes.
9. A patient with a single ventricle VAD experiences complications with the pump, requiring its replacement. The provider performs the necessary procedure and documents all relevant information for billing.
10. In a biventricular VAD, both pumps need to be replaced due to medical reasons. The provider performs the replacement procedure and ensures accurate documentation for billing.