How To Use CPT Code 33999

CPT 33999 describes a specific type of cardiac surgery procedure for which there is no specific code available. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 33999?

CPT 33999 is a code used to report surgical procedures on the heart that do not have a specific code available. It is used when the provider performs a surgical procedure on the heart that is not represented by any of the standard and active CPT codes. This code should only be used when there is no other specific procedure or service code that accurately describes the service provided.

2. Official Description

The official description of CPT code 33999 is: ‘Unlisted procedure, cardiac surgery.’ This code is used when there is no specific code available to accurately describe the surgical procedure performed on the heart.

3. Procedure

1. The provider performs a surgical procedure on the heart that is not represented by any of the standard and active CPT codes.
2. The procedure may involve various techniques and approaches depending on the specific needs of the patient and the condition being treated.
3. It is important for the provider to document the details of the procedure, including the specific techniques used and any additional procedures performed.
4. The documentation should also include any relevant pre-operative and post-operative care provided to the patient.

4. Qualifying circumstances

CPT 33999 can be used when there is no specific code available to accurately describe the surgical procedure performed on the heart. This may occur when the procedure is new or innovative, or when it is a variation of an existing procedure that is not adequately represented by the available codes. It is important for the provider to ensure that proper documentation has been done before billing for an unlisted procedure.

5. When to use CPT code 33999

CPT code 33999 should be used when there is no specific code available to accurately describe the surgical procedure performed on the heart. It should only be used when there is no other specific procedure or service code that accurately represents the service provided. It is important to follow CPT guidelines and not choose a code that merely approximates the service provided.

6. Documentation requirements

To support a claim for CPT code 33999, the provider must ensure that proper documentation has been done. This includes:

• A detailed description of the surgical procedure performed on the heart
• Documentation of any additional procedures performed
• Documentation of any relevant pre-operative and post-operative care provided to the patient
• A cover letter explaining the reason for choosing the unlisted code instead of a defined, active code
• Comparison to one or more similar codes to justify the claim amount
• Inclusion of operative notes and/or other relevant documentation to strengthen the claim

7. Billing guidelines

When billing for CPT code 33999, it is important to follow the billing guidelines. This includes:

• Submitting a cover letter explaining the reason for choosing the unlisted code instead of a defined, active code
• Comparing the service to one or more similar codes to justify the claim amount
• Including operative notes and/or other relevant documentation to strengthen the claim and avoid a possible denial
• Understanding that payers will consider claims with unlisted procedure codes on a case-by-case basis and determine payment based on the documentation provided

8. Historical information

CPT code 33999 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A surgeon performs a complex surgical procedure on the heart to repair a congenital defect that does not have a specific code available.
2. A cardiac surgeon performs an innovative procedure to treat a rare condition affecting the heart.
3. A provider performs a unique surgical procedure on the heart to address a complex cardiac issue.
4. A surgeon performs a variation of an existing procedure on the heart that is not adequately represented by the available codes.
5. A cardiac surgeon performs a specialized procedure on the heart to treat a specific condition that does not have a specific code available.