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The CPT® Code 33254 refers to the operative tissue ablation and reconstruction of the atria, specifically describing a limited approach such as the modified maze procedure. This surgical intervention is primarily aimed at correcting chronic atrial fibrillation, a condition characterized by rapid and uncoordinated contractions of the upper chambers of the heart, leading to an irregular and often rapid heartbeat. The modified maze procedure is designed to create new electrical pathways within the heart, allowing for the proper conduction of electrical impulses. This is crucial for restoring normal heart rhythm and function.
During the procedure, a midline sternotomy is performed to gain access to the chest cavity. The surgeon then makes an incision in the atrium through the interatrial groove and excises the atrial appendage. This step is essential for addressing the areas of the heart that contribute to the abnormal electrical activity associated with atrial fibrillation. Following this, precise incisions are made in the atrial tissue, and ablation lines are created to disrupt the conduction of these abnormal impulses. This process facilitates the normal flow of electrical signals from the sinoatrial node, which is the heart's natural pacemaker, to the atrioventricular node, thereby helping to restore the atria to a more normal size and function.
The modified maze procedure can be performed on either the left atrium alone or on both atria, depending on the specific needs of the patient. After the necessary incisions and ablation lines are created, the incision sites are sutured to promote healing. Notably, the modified maze procedure may incorporate various techniques to enhance its effectiveness and reduce recovery time. These techniques can include altered atriotomies that avoid disrupting the sinus node artery, the use of cryo- or radiofrequency ablation to create tissue lesions or ablation lines, and electrophysiological exclusion of the atrial appendage rather than its anatomical removal. Overall, this procedure represents a critical intervention for patients suffering from chronic atrial fibrillation, aiming to restore normal heart rhythm and improve overall cardiac function.
© Copyright 2025 Coding Ahead. All rights reserved.
The modified maze procedure, represented by CPT® Code 33254, is indicated for patients suffering from chronic atrial fibrillation. This condition is characterized by:
The modified maze procedure involves several critical steps to effectively address chronic atrial fibrillation:
Post-procedure care following the modified maze procedure involves monitoring the patient for any complications and ensuring proper recovery. Patients may require a period of hospitalization for observation and management of any potential arrhythmias or other cardiac issues. Follow-up appointments are essential to assess the effectiveness of the procedure and to monitor the patient's heart rhythm. Additionally, patients may need to adhere to specific medication regimens to support heart function and prevent thromboembolic events. Overall, the recovery process is critical for achieving the desired outcomes of the procedure and restoring normal cardiac function.
| Short Descr | ABLATE ATRIA LMTD | Medium Descr | ABLATION & RECONSTRUCTION ATRIA LIMITED | Long Descr | Operative tissue ablation and reconstruction of atria, limited (eg, modified maze procedure) | 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) | P2B - Major procedure, cardiovascular-Aneurysm repair | MUE | 1 | CCS Clinical Classification | 49 - Other OR heart procedures |
| AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient 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). | 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). | 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. | 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | GC | This service has been performed in part by a resident under the direction of a teaching physician |
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| 2011-01-01 | Changed | Short description changed. |
| 2007-01-01 | Added | First appearance in code book in 2007. |
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