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Operative tissue ablation and reconstruction of the atria, as described by CPT® Code 33258, refers to a specialized surgical procedure aimed at correcting chronic atrial fibrillation, which is characterized by rapid and uncoordinated contractions of the upper chambers of the heart, leading to an irregular and often rapid heartbeat. This extensive procedure is typically performed during another cardiac operation, such as a maze procedure, which is designed to create new electrical pathways in the heart. These pathways help to interrupt the abnormal electrical signals that cause atrial fibrillation, thereby restoring normal heart rhythm. The procedure is conducted without the use of cardiopulmonary bypass, distinguishing it from similar procedures that may require this support. The maze procedure involves making precise incisions in the atrial tissue to prevent the conduction of errant electrical impulses, allowing for the restoration of normal electrical activity from the sinoatrial node to the atrioventricular node. This surgical intervention not only aims to restore normal contractions of the atria but also to improve their size and function, enabling them to effectively pump blood into the ventricles. The careful execution of this procedure is critical for achieving the desired outcomes in patients suffering from atrial fibrillation.
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The procedure described by CPT® Code 33258 is indicated for patients suffering from chronic atrial fibrillation, which is characterized by rapid and uncoordinated contractions of the atria. This condition can lead to various complications, including an irregular and often rapid heartbeat. The maze procedure, which involves extensive operative tissue ablation and reconstruction of the atria, is performed to correct this arrhythmia and restore normal heart function. The procedure is typically indicated when other treatment options have been considered or when it is performed concurrently with another cardiac procedure.
The procedure involves several critical steps to ensure effective ablation and reconstruction of the atria.
After the procedure, patients are typically monitored in a recovery area to assess their vital signs and overall condition. Post-operative care may include pain management, monitoring for any complications, and ensuring that the heart is functioning properly. Patients may require follow-up visits to evaluate the success of the procedure and to monitor for any recurrence of atrial fibrillation. Rehabilitation and lifestyle modifications may also be recommended to support heart health and prevent future episodes of arrhythmia.
| Short Descr | ABLATE ATRIA X10SV ADD-ON | Medium Descr | ATRIA ABLTJ & RCNSTJ W/OTHER PX EXTENSIV W/O BYP | Long Descr | 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) | Status Code | Active Code | Global Days | ZZZ - Code Related to Another Service | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No 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) | 0 - Co-surgeons not permitted for this procedure. | 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 |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 33130 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Resection of external cardiac tumor | 33250 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article 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 | 33300 | MPFS Status: Active Code APC C Physician Quality Reporting Illustration for Code Repair of cardiac wound; without bypass | 33310 | MPFS Status: Active Code APC C Physician Quality Reporting Illustration for Code Cardiotomy, exploratory (includes removal of foreign body, atrial or ventricular thrombus); without bypass | 33320 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Suture repair of aorta or great vessels; without shunt or cardiopulmonary bypass | 33321 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Suture repair of aorta or great vessels; with shunt bypass | 33330 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Insertion of graft, aorta or great vessels; without shunt, or cardiopulmonary bypass | 33365 | MPFS Status: Active Code APC C Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; transaortic approach (eg, median sternotomy, mediastinotomy) | 33420 | MPFS Status: Active Code APC C Illustration for Code Valvotomy, mitral valve; closed heart | 33501 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Repair of coronary arteriovenous or arteriocardiac chamber fistula; without cardiopulmonary bypass | 33502 | Modifier 63 Exempt MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Repair of anomalous coronary artery from pulmonary artery origin; by ligation | 33503 | Modifier 63 Exempt MPFS Status: Active Code APC C Illustration for Code Repair of anomalous coronary artery from pulmonary artery origin; by graft, without cardiopulmonary bypass | 33510 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Coronary artery bypass, vein only; single coronary venous graft | 33511 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Coronary artery bypass, vein only; 2 coronary venous grafts | 33512 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Coronary artery bypass, vein only; 3 coronary venous grafts | 33513 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Coronary artery bypass, vein only; 4 coronary venous grafts | 33514 | MPFS Status: Active Code APC C Physician Quality Reporting Illustration for Code Coronary artery bypass, vein only; 5 coronary venous grafts | 33516 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Coronary artery bypass, vein only; 6 or more coronary venous grafts | 33533 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Coronary artery bypass, using arterial graft(s); single arterial graft | 33534 | MPFS Status: Active Code APC C Physician Quality Reporting Coronary artery bypass, using arterial graft(s); 2 coronary arterial grafts | 33535 | MPFS Status: Active Code APC C Physician Quality Reporting Coronary artery bypass, using arterial graft(s); 3 coronary arterial grafts | 33536 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Coronary artery bypass, using arterial graft(s); 4 or more coronary arterial grafts | 33690 | Modifier 63 Exempt MPFS Status: Active Code APC C Illustration for Code Banding of pulmonary artery | 33735 | Modifier 63 Exempt MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Atrial septectomy or septostomy; closed heart (Blalock-Hanlon type operation) | 33750 | Modifier 63 Exempt MPFS Status: Active Code APC C Illustration for Code Shunt; subclavian to pulmonary artery (Blalock-Taussig type operation) | 33755 | Modifier 63 Exempt MPFS Status: Active Code APC C Illustration for Code Shunt; ascending aorta to pulmonary artery (Waterston type operation) | 33762 | Modifier 63 Exempt MPFS Status: Active Code APC C Illustration for Code Shunt; descending aorta to pulmonary artery (Potts-Smith type operation) | 33764 | MPFS Status: Active Code APC C Illustration for Code Shunt; central, with prosthetic graft | 33766 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Shunt; superior vena cava to pulmonary artery for flow to 1 lung (classical Glenn procedure) | 33800 | MPFS Status: Active Code APC C Aortic suspension (aortopexy) for tracheal decompression (eg, for tracheomalacia) (separate procedure) | 33802 | Changed Code for 2025 MPFS Status: Active Code APC C Division of aberrant vessel (vascular ring); | 33803 | MPFS Status: Active Code APC C Division of aberrant vessel (vascular ring); with reanastomosis | 33820 | MPFS Status: Active Code APC C Repair of patent ductus arteriosus; by ligation | 33822 | Age Edit MPFS Status: Active Code APC C Repair of patent ductus arteriosus; by division, younger than 18 years | 33824 | Age Edit MPFS Status: Active Code APC C Repair of patent ductus arteriosus; by division, 18 years and older | 33840 | MPFS Status: Active Code APC C Excision of coarctation of aorta, with or without associated patent ductus arteriosus; with direct anastomosis | 33845 | MPFS Status: Active Code APC C Excision of coarctation of aorta, with or without associated patent ductus arteriosus; with graft | 33851 | MPFS Status: Active Code APC C Excision of coarctation of aorta, with or without associated patent ductus arteriosus; repair using either left subclavian artery or prosthetic material as gusset for enlargement | 33852 | MPFS Status: Active Code APC C CPT Assistant Article Repair of hypoplastic or interrupted aortic arch using autogenous or prosthetic material; without cardiopulmonary bypass | 33875 | MPFS Status: Active Code APC C Descending thoracic aorta graft, with or without bypass | 33877 | MPFS Status: Active Code APC C Physician Quality Reporting Repair of thoracoabdominal aortic aneurysm with graft, with or without cardiopulmonary bypass | 33915 | MPFS Status: Active Code APC C PUB 100 Pulmonary artery embolectomy; without cardiopulmonary bypass | 33925 | MPFS Status: Active Code APC C Repair of pulmonary artery arborization anomalies by unifocalization; without cardiopulmonary bypass | 33981 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Replacement of extracorporeal ventricular assist device, single or biventricular, pump(s), single or each pump | 33982 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Replacement of ventricular assist device pump(s); implantable intracorporeal, single ventricle, without cardiopulmonary bypass |
| AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | 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). | 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 | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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Notes
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| 2017-01-01 | Changed | Guidelines changed. |
| 2013-01-01 | Changed | Medium Descriptor changed. |
| 2011-01-01 | Changed | Short description changed. |
| 2008-01-01 | Added | First appearance in code book in 2008. |
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