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The CPT® Code 33250 refers to the operative ablation of a supraventricular arrhythmogenic focus or pathway, which includes conditions such as Wolff-Parkinson-White syndrome and atrioventricular node re-entry. These conditions are characterized by the presence of additional electrical pathways that can lead to episodes of supraventricular tachycardia, a type of rapid heart rate originating above the ventricles. The procedure is performed without the use of cardiopulmonary bypass, meaning that the heart remains beating throughout the operation. Access to the heart is typically achieved through a midline sternotomy, which involves making an incision along the sternum. During the procedure, both epicardial and endocardial electrodes are placed on the heart to facilitate pacing and mapping, allowing the medical team to accurately locate the abnormal electrical pathways responsible for the arrhythmia. The ablation itself can be performed using various techniques, including surgical incision, cryoablation, or radiofrequency ablation, to effectively destroy the abnormal pathways. Following the ablation, the heart incision is closed, and if cardiopulmonary bypass was not utilized, the procedure concludes without the need for additional support systems. This code is specifically designated for cases where the ablation is performed on a beating heart, distinguishing it from similar procedures that may require the heart to be stopped and cardiopulmonary bypass to be established.
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The procedure represented by CPT® Code 33250 is indicated for patients experiencing specific types of supraventricular arrhythmias, particularly those associated with the following conditions:
The procedure for CPT® Code 33250 involves several critical steps to ensure the effective ablation of the arrhythmogenic focus or pathway:
Post-procedure care following the ablation involves monitoring the patient for any complications and ensuring proper recovery. Patients may require observation in a recovery area to assess their heart rhythm and overall stability. The placement of chest tubes, if necessary, aids in draining any excess fluid and preventing complications such as pneumothorax. The recovery period will vary based on individual patient factors, but the goal is to ensure that the heart is functioning normally and that the arrhythmia has been successfully addressed. Follow-up appointments will be necessary to evaluate the long-term effectiveness of the procedure and to monitor for any recurrence of arrhythmias.
| Short Descr | ABLATE HEART DYSRHYTHM FOCUS | Medium Descr | ABLATION ARRHYTHMOGENIC FOCI/PATHWAY W/O BYPASS | Long Descr | Operative ablation of supraventricular arrhythmogenic focus or pathway (eg, Wolff-Parkinson-White, atrioventricular node re-entry), tract(s) and/or focus (foci); without cardiopulmonary bypass | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P2F - Major procedure, cardiovascular-Other | MUE | 1 | CCS Clinical Classification | 49 - Other OR heart procedures |
This is a primary code that can be used with these additional add-on codes.
| 33257 | Addon Code MPFS Status: Active Code APC C Illustration for Code Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), limited (eg, modified maze procedure) (List separately in addition to code for primary procedure) | 33258 | Addon Code MPFS Status: Active Code APC C Illustration for Code Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), extensive (eg, maze procedure), without cardiopulmonary bypass (List separately in addition to code for primary procedure) |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 53 | Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician |
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| 2002-01-01 | Changed | Code description changed. |
| 1990-01-01 | Added | First appearance in code book in 1990. |
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