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Endoscopic operative tissue ablation and reconstruction of the atria, specifically through the extensive maze procedure, is a surgical intervention aimed at addressing chronic atrial fibrillation. Atrial fibrillation is characterized by rapid and uncoordinated contractions of the atrial muscles, leading to an irregular and often rapid heartbeat. This procedure is particularly suitable for patients diagnosed with lone atrial fibrillation, meaning they do not have other underlying cardiac conditions. The extensive maze procedure, denoted by CPT® Code 33266, is performed without the use of cardiopulmonary bypass, allowing for a less invasive approach. Utilizing a robotic-assisted technique, the surgeon creates small puncture wounds in the chest to access the heart. Through these access points, abnormal electrical pathways within the atria are ablated, which helps to restore normal electrical conduction. Additionally, the procedure may involve the resection of the atrial appendage, further contributing to the correction of the fibrillation. The ultimate goal of this surgical intervention is to eliminate the fibrillation, thereby stabilizing the heart's rhythm and improving the patient's overall cardiac function.
© Copyright 2025 Coding Ahead. All rights reserved.
The extensive maze procedure, represented by CPT® Code 33266, is indicated for patients suffering from chronic atrial fibrillation. This condition is characterized by rapid and uncoordinated contractions of the atrial muscles, leading to an irregular heartbeat. The procedure is particularly suitable for individuals with lone atrial fibrillation, which occurs in the absence of other cardiac diseases. The goal of the procedure is to restore normal heart rhythm and improve overall cardiac function.
The extensive maze procedure involves several critical steps to ensure effective ablation and reconstruction of the atria. Each step is designed to address the abnormal electrical pathways that contribute to atrial fibrillation.
Following the extensive maze procedure, patients typically experience a recovery period that may vary in duration depending on individual health factors. Post-procedure care includes monitoring for any complications, such as bleeding or infection at the puncture sites. Patients may be advised to follow a specific medication regimen to manage heart rhythm and prevent thromboembolic events. Regular follow-up appointments are essential to assess the effectiveness of the procedure and to monitor the patient's heart rhythm. The expected outcome is a significant reduction or elimination of atrial fibrillation episodes, leading to improved quality of life and cardiac function.
| Short Descr | ABLATE ATRIA X10SV ENDO | Medium Descr | NDSC ABLATION & RCNSTJ ATRIA EXTEN W/O BYPASS | Long Descr | Endoscopy, surgical; operative tissue ablation and reconstruction of atria, extensive (eg, maze procedure), 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) | 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 | 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). | 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. | 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). | 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). | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 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). | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician | KX | Requirements specified in the medical policy have been met | LT | Left side (used to identify procedures performed on the left side of the body) | Q0 | Investigational clinical service provided in a clinical research study that is in an approved clinical research study |
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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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