© Copyright 2025 American Medical Association. All rights reserved.
The CPT® Code 33251 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 involves a midline sternotomy, which is a surgical incision made along the sternum to provide access to the heart. During the operation, 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. If necessary, cardiopulmonary bypass is established to temporarily take over the function of the heart and lungs, allowing for a controlled environment during the procedure. The right atrium is then incised to access the abnormal pathways, which are subsequently destroyed through surgical incision, cryoablation, or radiofrequency ablation techniques. Following the ablation, the heart incision is closed, and if cardiopulmonary bypass was utilized, it is discontinued. Chest tubes may be placed as needed to drain any fluid, and the chest incision is then closed. This code is specifically used when the ablation procedure is performed with the heart stopped and cardiopulmonary bypass in place, distinguishing it from similar procedures performed on a beating heart, which would be reported with CPT® Code 33250.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure associated with CPT® Code 33251 is indicated for patients experiencing specific types of supraventricular arrhythmias, particularly those caused by abnormal electrical pathways. The following conditions are explicitly mentioned as indications for this procedure:
The procedure for CPT® Code 33251 involves several critical steps to ensure the effective ablation of the arrhythmogenic focus or pathway:
Post-procedure care following the ablation with CPT® Code 33251 includes monitoring the patient for any complications that may arise from the surgery. Patients are typically observed in a recovery area where vital signs are closely monitored. The expected recovery period may vary depending on the individual patient's condition and the extent of the procedure performed. Patients may experience some discomfort or pain at the incision sites, which can be managed with appropriate pain relief measures. Follow-up appointments are essential to assess the success of the ablation and to monitor for any recurrence of arrhythmias. Additionally, patients may be advised on activity restrictions and the importance of adhering to prescribed medications to support heart health and prevent future arrhythmias.
| Short Descr | ABLATE HEART DYSRHYTHM FOCUS | Medium Descr | ABLATION ARRHYTHMOGENIC FOCI/PATHWAY W/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); with 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) | 33259 | 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), with cardiopulmonary bypass (List separately in addition to code for primary procedure) | 34714 | Addon Code MPFS Status: Active Code APC N ASC N1 Open femoral artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by groin incision, unilateral (List separately in addition to code for primary procedure) | 34716 | Addon Code MPFS Status: Active Code APC N ASC N1 Open axillary/subclavian artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by infraclavicular or supraclavicular incision, unilateral (List separately in addition to code for primary procedure) | 34833 | Addon Code Resequenced Code MPFS Status: Active Code APC C CPT Assistant Article Open iliac artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by abdominal or retroperitoneal incision, unilateral (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). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2002-01-01 | Changed | Code description changed. |
| 1990-01-01 | Added | First appearance in code book in 1990. |
Get instant expert-level medical coding assistance.