How To Use CPT Code 33990

CPT 33990 describes the percutaneous insertion of a ventricular assist device (VAD) into the left heart, using arterial access only, under radiological supervision and interpretation. 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 33990?

CPT 33990 can be used to describe the percutaneous insertion of a ventricular assist device (VAD) into the left heart, specifically using arterial access only. This procedure is performed under radiological guidance and supervision. The VAD is a mechanical pump that helps support a weakened heart or a heart in failure by assisting in pumping blood from the heart to other organs of the body.

2. Official Description

The official description of CPT code 33990 is: ‘Insertion of ventricular assist device, percutaneous, including radiological supervision and interpretation; left heart, arterial access only.’

3. Procedure

1. The patient is appropriately prepped and anesthetized for the procedure.
2. The provider makes an incision to access an artery, such as the femoral artery, which is the main blood vessel of the leg.
3. Using radiologic guidance, the provider threads a catheter through the arterial system to the left heart.
4. The ventricular assist device (VAD) is attached to the left ventricle, which pumps blood from the left ventricle into the aorta to reduce the workload of the ventricle.
5. The provider completes the necessary steps to ensure the VAD is securely in place and functioning properly.
6. The access site is closed, and the procedure is concluded.

4. Qualifying circumstances

CPT 33990 is used when a ventricular assist device (VAD) is percutaneously inserted into the left heart using arterial access only. This procedure is typically performed on patients with a weakened heart or heart failure. The provider must use radiological supervision and interpretation during the procedure.

5. When to use CPT code 33990

CPT code 33990 should be used when a ventricular assist device (VAD) is percutaneously inserted into the left heart using arterial access only. It is important to ensure that the procedure meets the specific criteria outlined in the code description, including the use of radiological supervision and interpretation.

6. Documentation requirements

To support a claim for CPT 33990, the provider must document the following information:

• Indication for the procedure and the need for a ventricular assist device (VAD)
• Specific details of the procedure, including the use of arterial access only and radiological guidance
• Date and duration of the procedure
• Any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 33990, ensure that the procedure meets the specific criteria outlined in the code description. It is important to accurately document the use of arterial access only and radiological supervision and interpretation. Additionally, be aware of any specific billing guidelines or requirements from insurance providers or payers.

8. Historical information

CPT 33990 was added to the Current Procedural Terminology system on January 1, 2013. The code description was updated on January 1, 2021 to specify ‘arterial access only’.

9. Examples

1. A patient with severe heart failure undergoes percutaneous insertion of a ventricular assist device (VAD) into the left heart using arterial access only.
2. A provider performs a percutaneous VAD insertion procedure on a patient with a weakened heart, using arterial access only and radiological guidance.
3. A patient with end-stage heart failure receives a ventricular assist device (VAD) through percutaneous insertion into the left heart, utilizing arterial access only.
4. A provider performs a percutaneous VAD insertion procedure on a patient with a failing left ventricle, using arterial access only and radiological supervision.
5. A patient with cardiomyopathy undergoes a percutaneous VAD insertion procedure, utilizing arterial access only and radiological guidance.
6. A provider performs a percutaneous VAD insertion procedure on a patient with severe heart failure, using arterial access only and radiological interpretation.
7. A patient with advanced heart failure receives a ventricular assist device (VAD) through percutaneous insertion into the left heart, utilizing arterial access only.
8. A provider performs a percutaneous VAD insertion procedure on a patient with a weakened left ventricle, using arterial access only and radiological supervision.
9. A patient with end-stage heart disease undergoes a percutaneous VAD insertion procedure, utilizing arterial access only and radiological guidance.
10. A provider performs a percutaneous VAD insertion procedure on a patient with severe heart failure, using arterial access only and radiological interpretation.